Public Inquiry Form: Collections

*Fields marked with an asterisk are required.

Submit Your Questions About Collections

Subject:

Last Name:

First Name:

Mailing Address:

City:

State:

ZIP Code:

Email Address:

Telephone Number:

Fax Number:

Required Information of Account Holder

Account Holder Name:

Account Holder Address:

Account Holder Phone Number:

Account Reference Number: (e.g., Case/Docket, MR, etc.) - type "NONE" if not available

Request Explanation

Please explain your request for asssitance (be brief but specific):

Quick Links

Make a Payment Make an Appointment Online Public Inquiry Form Internal Revenue Services California Franchise Tax Board (FTB)Finance Agency Valley Medical Center California FTB Court Ordered Debt (COD) Program California FTB Intercept Program Weekend Work Program Santa Clara County Superior Court Family Court Services Learn More About Victim Compensation and Restitution Victim Services—Office of the District Attorney

©2023 County of Santa Clara. All rights reserved.