ADA Assisted Collections

Complete steps 1 and 2 to request ADA Assisted Collections Service.

Required *

I need Assisted Collection Service.

Please select a request type.

Please select the date.

Enter the address in need of ADA Assisted Collections. If needed, adjust the red marker on the map below.

Enter the location of the problem or click and drag the map marker.

Update the address here.

Please verify that the address of the issue you are reporting is within the City limits. Try selecting an address from the address suggestion list. Learn More

Please enter a street.

Please enter a city.

Please enter valid city.

Please enter a state.

Please enter a valid state.

Please enter a valid zipcode.

Please enter a zipcode.

Please check the checkbox.

No able bodied person is available to help me set out my automated container. *

Contact Information

Please provide your contact information.

Please enter your first name.

Please enter a valid first name.

Please enter your last name.

Please enter a valid last name.

Please enter your email address.

Please enter a valid email address.

Please enter your phone number.

Please enter a valid phone number.

Please enter your street.

Please enter a valid street.

Please enter your city.

Please enter a valid city.

Please enter your state.

Please enter a valid Sstate.

Please enter your zipcode.

Please enter a valid zipcode.

ADA Assisted Collections Details

Verify the details below and click submit to request ADA Assisted Collections.

Name:

Email:

Phone:

Address: , ,

ADA Request Type:

I certify under penalty of perjury, under the laws of the state of California, that the foregoing information is true and correct.

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ADA Assisted Collections

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ADA Assisted Collections Details

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