Home Public Inquiry Form: Collections Public Inquiry Form: Collections *Fields marked with an asterisk are required. Submit Your Questions About Collections Subject: - Select -General InquiryAbout DTACAddress/Demographic InformationBilling StatementLiensMy Account - Summary or Formal ProbationMy Account - TrafficMy Account - Medical CollectionsMy Account - Legal and General CollectionsMy Account - OtherOffice Location and HoursPaymentReturned PaymentVictim RestitutionMiscellaneous 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): Leave this field blank 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
Subject: - Select -General InquiryAbout DTACAddress/Demographic InformationBilling StatementLiensMy Account - Summary or Formal ProbationMy Account - TrafficMy Account - Medical CollectionsMy Account - Legal and General CollectionsMy Account - OtherOffice Location and HoursPaymentReturned PaymentVictim RestitutionMiscellaneous 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): Leave this field blank
