internal.assetcollect.com Open in urlscan Pro
2a06:98c1:3121::3  Public Scan

Form analysis
1 forms found in the DOM

Name: debtor-communication — POST

<form name="debtor-communication" method="post">
  <div class="float-left autopay-column">
    <p>Enter the <b>Debtor's email address:</b><br><input type="email" name="debtor-email" size="35" required="required" tabindex="1"></p>
    <p>Enter the <b>Amount Due:</b><br><input type="amount" name="amount-due" size="35" required="required" tabindex="1"></p>
    <p>Enter the <b>Debtor's FACS account #:</b><br><input type="text" name="debtor-account" size="7" maxlength="7" required="required" pattern="[0-9]{6,7}" tabindex="2"></p>
    <!--
	<p>Enter <b>your (collector's) email address:</b><br /><input type="text" name="collector-email" size="40" tabindex="3"></p>
-->
  </div>
  <div class="float-right autopay-column" style="border:none;">
    <p>Which <b>form</b> do you want to send to the debtor?</p>
    <p><input type="submit" name="ARG Autopay Form" formaction="dc-arg-autopay.php" value="ARG Autopay Form"><br>
      <input type="submit" name="ASI Autopay Form" formaction="dc-asi-autopay.php" value="ASI Autopay Form">
    </p>
  </div>
</form>

Text Content

THIS IS A PRIVATE FORM FOR INTERNAL USE BY EMPLOYEES OF ASSET RECOVERY GROUP,
INC.

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ARG is at 503-230-9522,
or toll free at 800-458-6368



ASI is at 503-233-0462,
or toll free at 800-553-2406

Enter the Debtor's email address:


Enter the Amount Due:


Enter the Debtor's FACS account #:


Which form do you want to send to the debtor?




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