Tulsa Adjustment Bureau

Tulsa Adjustment Bureau
Secure Payment Form

Payment Summary:

Date:

12/21/24

Amount(min. $50):

TAB Services Account No. or Last 4 of SSN:

Credit Card Information:

Card Type:

Name as on Card:

Card Billing Address:

Card Billing Zipcode:

Card Number:

Card Expiration Date:

MMYY

Card ID (CVV2/CID) Number:
[What is the Card ID?]

Email Address:

Phone Number:

There will be a $25.00 service fee on all returned checks. This communication is from a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose.