Debt Collection Department

Your Details
NAME OF CREDITOR……………………………………………………………
TRADING ADDRESS ……………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
REGISTERED OFFICE (if different) ……………………………………………
………………………………………………………………………………………
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CONTACT NAME…………………………………………………………………

 

Your Debtor’s Details
NAME OF DEBTOR………………………………………………………………
Is the debtor an individual, firm or company?………………………………….
REGISTERED NUMBER (if a company)……………………………………….
REGISTERED OFFICE…………………………………………………………..
………………………………………………………………………………………
………………………………………………………………………………………
TRADING ADDRESS (if different) ………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………

 

The Debt
*AMOUNT OF DEBT………………………………………(inclusive of VAT)
Does debt relate to goods sold and delivered, services rendered or other?
If other, please specify……………………………………………………………
………………………………………………………………………………………
DATE & NUMBERS OF INVOICES…………………………………………….
………………………………………………………………………………………
DATES & AMOUNTS OF PAYMENTS……………………………………….
………………………………………………………………………………………
How many days after delivery of invoice was payment due?………………..
Are invoices disputed?……………………………………………………………
If yes, please provide copies of relevant correspondence
(If possible Debtor’s letter heading will assist)
Have any cheques paid to you been dishonoured?…………………………
Are you aware of the location of any specific assets?………………………
Do you have any special instructions?…………………………………………
*Notify your solicitor if you wish to claim Late Payment Act interest and
Compensation for Late Payment.