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For Office Use Only Adjustment Removal 1st 2nd Date adjustment completed By Customer Service Representative Revised 01/27/2017. Submittal of this adjustment form does not prevent your account from further action in compliance with CCU s Credit and Collections policy. I am aware that I am responsible for any unpaid balance on my account and that submittal of this form does not prevent my account from further collection action in compliance with CCU s Credit and Collections Policy. I have read...
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