Welcome to KKV Recovery Services, Inc.

Vince Struffolino,
President

Email ::
KKTow3@aol.com

Please complete form entirely in order for us to expedite this assignment.

Fields marked ' * ' are compulsory.

* Date:

Time:

* Email Address:

* Assigning Client:

* Client Account #:

* Client's Address:

* City, Zip, State:

* Assigning Adjuster:

* Phone #:

Fax #:

Toll Free #:

* Debtor:

* Home Address:

* City, State, Zip:

* Phone #:

DOB:

SS#:

DL#:

POB:

POB Address:

POB Phone #:

Department:

Co-Maker:

Phone #:

Relatives,Contacts,References:

Additional Information:

Special Instructions:

Voluntary:

Involuntary:

* Vehicle (Year/Make/Model):

Vin #:

* Color:

Key Code:

Tag#:

State:

Exp:

Gross Balance:

Monthly Payment:

Past Due Date:

Last Paid: