Subscription Form - DCA - Debt Control Agency

DCA

Schedule your recurring payments

Simplify Managing Your Debt

Recurring payments make it easy to manage your outstanding debt by automatically scheduling payments. This helps you pay off your balance in smaller, manageable amounts without the stress of missed deadlines or additional fees. It’s a hassle-free way to stay on track and regain control of your financial obligations.

Recurring Payment

Getting Started

To set up your recurring payments, follow the questions below carefully and have your DCA (your file number) ready—this is essential to proceed. Your DCA Number, which begins with two letters followed by six digits (e.g., DD123456), can be found on the letter, email, or text message you received from us. If you’re unsure about any step, don’t hesitate to contact us at 1-866-307-5322 or email us at customercare@debtcontrolagency.com, and our team will gladly assist you.

By completing this transaction, you agree to fulfill recurring payment obligations. A $50 fee may apply for defaults. Contact us with any concerns

Enter Cardholder’s information

Schedule your recurring payments

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

DCA#(Required)

This file number can be found in the text message, e-mail or letter you received from us – it begins with two letters, followed by six digits (ex. DD123456)

Customer Name(Required)

Recurring Amount(Required)

Total recurring amount for all installments

Payment Count(Required)

Please enter a number greater than or equal to 1.

The number of payments before the recurring plan is complete.

Recurring Payment Installement

Recurring amount paid per installment

Total Amount

Billing Frequency Type(Required)

Choose how often you would like to be billed for this subscription. You can select a daily frequency (e.g., every 7 days) or a monthly frequency (e.g., every two month).

Daily Frequency(Required)

Please enter a number from 1 to 30.

If you would like to make a payment every 2 days, (enter 2) once every 7 days, (enter7) or any interval between 1 and 30 days.

Monthly Frequency(Required)

Please enter a number from 1 to 12.

Day of the Month for Billing(Required)

Please enter a number from 1 to 31.

Select the specific day of the month on which you would like to be billed (e.g., 1 for the 1st of the month, 15 for the 15th of the month).

Recurring Start Date(Required)

Select the date on which you would like your subscription billing to begin. This determines when the first payment will be processed and the recurring schedule will start.

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name