Payments – ECG DEBT COLLECTION CORP

Electronic Payment to ECG Corp.

Please note: all fields on this form are required

First Name

Last name

Address 1

Address 2

City

State

zip code

Your phone

E-MAIL

Bank Name

Bank Routing number

Confirm bank routing number

Bank Account Number

Confirm Bank Account Number

Check number

Payment amount (min $250 required)

Consent

I authorize ECG Corp. to charge my bank account with the above information provided for the agreed upon payment(s). I understand that my information will be saved to file for future transactions on my account.

Contact Us

ECG Debt Collection Corporation.

30-97 Steinway Street, Suite 205, 2nd Flr.

Astoria, NY 11103

Tel: 718-932-9300 Toll Free 800-918-8232

Fax: 718-932-9303

Electronic Payment to ECG Corp.

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