A.R. Systems Inc. - Submit An Account For Collection

Submit Your Individual Accounts On-Line for Collection

To submit a commercial claim on-line, please complete the form below and click the submit button. You may also print a PDF of this form and fax it to: 602-864-0297. For submitting consumer claims or multiple accounts, see the menu above.

*If you are an existing customer of A.R Systems, Inc., please click “Access Your Account” and then click “New Account Entry” to submit a claim. If you do not know your account number or password, or would like to phone or fax in your claims, please call your account executive.

Toll Free: 1-877-595-5449
Fax: 602-864-0297
Or Email: claims@arsystemsinc.com

*Required Field

Your Company Information:

Today’s Date:
Contact Name: Title:
Company Name:
Address:
City: State: ZIP:
Email Address:*
Phone: Fax:
Outline of products or services:

Business Claim Information

Business Name:
Contact:
Last Name: MI First Name:
Federal ID #:

Business Address

Address: Suite #
City: State: ZIP:
Phone 1: Mobile 1:
Phone 2: Mobile 2:
Email Address:

Debt Data

Principle Amount: Service Date:
Interest: Interest Assessed Through:
Last Charge Date: Last Payment Date:
Delinquency Date:
Account Type: Judgment Signed Contract Other
Personal Guarantee: No Yes (If "Yes" we will request their SSN later)
Name:
Phone Number SSN:
Debt Description:
Comments: