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Fields marked * are required

First name *

Surname *

Telephone *

Email *

Are you an existing client?

On what date do you say payment should have been received by and on what basis (ie, by reference to your standard terms and conditions of business)? *

What interest rate (if any) do you say applies to the debt and on what basis? *

What contact (if any) have you had with the debtor in respect of the unpaid monies? If by telephone, please provide full details of the conversation(s). *

Is there any reason (whatsoever) why the Defendant is not or may not be paying (ie, defective goods, poor services, set off etc) (even if the debtor has not yet informed you of this)? *

How long has the debtor been a customer? *

How many orders has it placed during this time? *

Has the debtor previously failed to pay an invoice? If so, what was the outcome? *

Have you previously instructed debt collectors or solicitors to pursue the debt? If so, what (if anything) did they achieve? *

Do you have any information of recent activities involving the debtor (such as it making redundancies, closing offices etc)? *

Does the debtor have a way in which it normally satisfies invoices ie, does it leave it to the last possible moment, or pay straight away etc? *

Do you know whether the debtor has any properties, cars or other assets? If so, please provide full details including addresses and makes, models and registration numbers of vehicles. *

Attachments

In order that we may consider your claim, it would be beneficial for us to have the following:

the invoice(s):
any contract that may have been entered into regarding the goods and/or services;
any terms and conditions of business that you may have sent to the debtor;
purchase order(s);
copies of any previous remittance advices by the debtor showing its bank account details; and
any documentation (of whatever nature) regarding the goods and/or services, which are covered by the unpaid invoice. This may include e-mails, letters, faxes whether complaining, trying to delay payment or otherwise.

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Terms and conditions

Please confirm that the answers provided above are true and accurate