Post-Bankruptcy Creditor Harassment Complaint Form
Use this Post-Bankruptcy Creditor Harassment Complaint Form to report creditor actions you believe violate your bankruptcy protections. Please provide as much detail as possible to help us address your complaint efficiently.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Type of Bankruptcy Filed
*
Please Select
Chapter 7
Chapter 13
Other / Not Sure
Date Bankruptcy Was Filed
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name of Creditor or Collection Agency
*
How did the creditor contact you?
*
Phone call
Text message
Email
Letter
In person
Other
Describe the harassment or collection activity
*
Upload any supporting documents or evidence (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Preferred Method of Contact
Email
Phone
Submit Complaint
Should be Empty: