Data secured using SSL 2048 bit encryption.
Use this form to make a payment on your account!

In order to assure that your payment is properly received and accurately applied to your account you must fully complete this form.

In order to make a payment, settlement offer, or payment plan; the following conditions must be true.
Please check each box where the condition is true.

File Number with our office
Last Name
Zip Code


Zarzaur & Schwartz, P.C. © 2007
2209 Morris Avenue • P.O.Box 11366 • Birmingham, AL 35203
Toll-free (800) 401-6789 • Phone (205) 250-8437 • Fax (205) 328-1958

We are required under state and federal law to notify consumers of the following rights. This list does not contain a complete list of the rights consumers have under state and federal law.

This is an attempt to collect a debt. Any information obtained will be used for that purpose. This is a communication from a debt collector. Consumers may request orally or in writing details regarding any debt being collected by Zarzaur & Schwartz, P.C., including an itemization of the principal balance owed, including an itemization of all fees, interest, and any other amount charged to the account.

For the complete text of the federal Fair Debt Collection Practices Act, please visit the FTC website at