Your Full Name

Job title

Organisation name

Company number

Street Address

City/County

Post Code

Telephone #

Email

Legal status of your organisation

Other:

Legal Address

Name

Phone

Address

Invoice information

Please supply the information below - this is essential

How many invoices?

Payment details

Total amount outstanding

Payment Terms (days)

Was your debtor dealing with you in the course of their business?

Yes
No

Do you charge Contractual Interest?

Yes
No

Confirmation

I confirm that I / my organisation wish to instruct London Bailiff Services and their agents to act on my / my organisations behalf in relation to the collection of the debt / debts as detailed above. I have authority to provide instructions on behalf of my organisation. I have read and accept your Terms & Conditions of Business and consent to information regarding this instruction being shared within the AWT Associates Ltd and their respective agents.

DEBT RECOVERY INSTRUCTION ONLINE FORM

Invoice information

Payment details

Confirmation