Phone: (614) 253-1010    


Collection Forms - How to Submit a Claim 

To submit a claim, please select the appropriate Collection form (cover sheet) for your collection claim(s).




Complete the Collection form as thoroughly as possible for each claim and attach a copy of your supporting documents.   Supporting documents will be different depending on the type of claim you are submitting.  A client Liaison can assist you in defining the supporting documents.    




Email your completed Assignment form and supporting documents to Be sure to include your contact information.




Note: We must first receive a signed Engagement Letter if you are a prospective new client that has chosen to engage our firm to represent you or your company in any matter.  Upon receipt of your information, a client liaison will be in touch within 24 hours to discuss your matter or claim in specific detail and explain all terms and conditions of the representation.

The use of the Internet or these forms for communication with our firm or any individual member of our firm does not establish an attorney-client relationship.  Confidential or time-sensitive information should not be sent through these forms.

Select a Collection form (cover sheet) for your Collection Claim…
Click on the desired form…

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Our Collection Firm Handles Collections Throughout The State of Ohio    



Why Our Firm Dana & Pariser Co., L.P.A.

Our People Attorneys At Law
Practice Areas 495 East Mound Street
Collection Forms Columbus, Ohio 43215
Contact Us Phone: (614) 253-1010
Home Page Fax: (614) 253-3310

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