Dispute Your Account

Disputed Account

This is an attempt to collect a debt by a debt collector and any information obtained will be used for that purpose.

Name^*

Address 1^*

Address 2

City^*

State^*

Zip

Email^*

By providing this email I am authorizing CCB to Contact me via my Email.

Phone^*

Day/Work Phone

Cell Phone

Account Number (if known)

Service Provider^*

(who sent the bill)

Please tell us why you are disputing this account and any other information pertaining to the bill, that may help in resolving it.^*