(a) A claimant shall suspend all collection activities that concern a debt identified by the debtor as coerced debt until the claimant has completed a review pursuant to subsection (f) of this section, if the debtor provides the claimant with information and documentation, certified by the debtor, that:
(1) Includes the following:
(A) An identification of the debt alleged to be coerced debt;
(B) A description of the circumstances under which the allegedly coerced debt was incurred;
(C) An attested to written statement by the debtor disclosing (i) that the debtor did not willingly authorize the use of the debtor's name or personal information to incur such debt, (ii) specific facts supporting the debtor's allegation, if available, and (iii) if the debtor alleges that only a portion of such debt is coerced debt, the portion of such debt that the debtor alleges is coerced debt;
(D) Any information known by the debtor, including, but not limited to, any credit card number, and the individual in whose name such debt was incurred;
(E) The identity of the individual whom the debtor alleges coerced the debtor into incurring such debt and contact information for such individual, if the debtor knows such contact information, unless the debtor signs a sworn statement that disclosing such information is likely to result in abuse to the debtor or any immediate family member of the debtor;
(F) A telephone number that the claimant may use to contact the debtor to obtain additional information from, or pose questions to, the debtor with regard to such debt, or, if the debtor prefers to communicate with the claimant in writing, a statement by the debtor indicating that the claimant shall communicate with the debtor with regard to such debt exclusively in writing and disclosing the debtor's mailing address, electronic mail address or both; and
(G) Any other documents the debtor deems appropriate to support the request.
(2) In support of the information disclosed pursuant to subdivision (1) of this subsection, attaches not less than one of the following:
(A) A police report;
(B) A restraining order or protective order issued by a court of competent jurisdiction; or
(C) A document prepared by a qualified third-party professional that (i) is based on information the qualified third-party professional received while acting in such qualified third-party professional's professional capacity, (ii) is certified by the qualified third-party professional in the manner specified in subsection (b) of this subsection, and (iii) displays the letterhead, address and telephone number of the office, institution, center or organization that has engaged or employs the qualified third-party professional regardless of whether such qualified third-party professional is financially compensated, or the letterhead, address and telephone number of such qualified third-party professional if such qualified third-party professional is self-employed.
(b) Each certification required pursuant to subsection (a) of this section shall be in substantially the following form:
“I declare under penalty of perjury that the representations made herein are true, correct, and contain no material omissions of fact.