Account Control Technology Inc.

(888) 830-7770

New Registration Form

User Details
User Name:
Password:
Confirm Password:
Account Information
ACT Account Number:
Last 4 digits of SSN:
Last Name:
Contact Information
Address:
City:
State:
State terms:
 
As of the date of the letter sent to you, you owe the amount stated on that letter. Because your credit agreement may require you to pay interest on the outstanding portion of your balance, as well as late charges and costs of recovery, which vary from day to day, as you agreed in your credit agreement, the amount required to pay your account in full on the day you send payment may be greater than the amount stated. If you pay the amount stated, an adjustment may be necessary after we receive your payment. In that event, we will notify you of any adjustment in your balance. We encourage you to call prior to making a payment intended to pay your account in full.
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Zip Code:
How may we contact you?
Phone:
Email:
    Accept Cell Phone Calls
Cell Phone Number:
Home Phone:
Length at Residence:
Your Employer Information
Name of Employer:
Address:
City:
State:
Zip Code:
Work Phone: Ext.
Length of Employment:
Monthly Gross: $ Monthly Net: $ Other Income: $
Spouse's Information
Name:
Creditor
Please reference the creditor which you owe:
   

Please add any additional information you wish to send below: