Please fill out the payment form below in it's entirety, press
  'Add this payment to the schedule' for each payment (up to 12)
  that you'd like to make, then press 'Submit Payment(s)' to complete.

LRS Reference# / Creditor Reference#, or Credit File#:	(See Example)
First Name:
Last Name:
Street Address
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Phone Number
Email Address
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Credit Card Number
Expiry Month/Year	01 - Jan 02 - Feb 03 - Mar 04 - April 05 - May 06 - June 07 - July 08 - August 09 - Sept 10 - Oct 11 - Nov 12 - Dec / 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 2045 2046 2047 2048 2049 2050
CVV Code	(See Example)
I understand this transaction will appear on my credit card statement as a credit card charge from "LOUISIANA RECOVERY SERVICES, INC.". By clicking the "Submit Payment(s)" button below, I am affirming that I understand and agree to this Credit Card Transaction(S). Additionally, I agree to a $7.00 transaction fee for each transaction. I further agree that nothing within this site shall be considered as an offer to settle any matter, unless otherwise agreed to by LOUISIANA RECOVERY SERVICES, INC. THIS COMMUNICATION IS FROM A DEBT COLLECTOR. THIS IS AN ATTEMPT TO COLLECT A DEBT BY A DEBT COLLECTOR AND ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE. I have read and agree to the above statement