Alpha Recovery Group, LLC
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an electronic transaction. You will be contacted to verify the payment information and to confirm the details of the transaction.
Original Creditor Account #
Name of Person Authorizing Payment
Authorized Payment Amount
Payment Date(s)
Email Address
Telephone (required for verification)
(
)
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Name and Address (as it appears on the check)
Bank Name
9 Digit Routing (ABA) #
Checking Account #
Check # (optional)
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