Debt Collection Instructions Form

Vilcol

Recovery/Debt Collection Instructions
1. If you are an existing client please fill in your details in the paragraph 1.1. If you are a new client please proceed to 1.2.
1.1 Existing Client Details
Your VILCOL Client Code	*
If you have forgotten your client code please complete your full details in 1.2 before proceeding to instruct us.
Your Name	**
Type of Recovery
When you have entered your client code, full name and type of investigation you can proceed to instruct us.
1.2 New Client/Company Details
Your Name	**
Your Company	*
Your Reference	*
Company Registration No	*
When you have entered your details you can proceed to instruct us.
If you wish to download your file/instructions please click this link, attach relevant documents to your email and put your company name into Subject line.
2. Details of the new instructions
2.1 Subject details
Subject Name	**
Subject title	Mr Mrs Ms Other
Other (Please Specify)
2.2 Type of Service Required
Recovery/Debt Collection
Other (Please Specify)
Subject Company
Subject Home Address	Address Line1 Address Line 2 Town County Post Code
Subject Home Tel. Subject Mobile Tel.
Subject Work Address	Address Line1 Address Line 2 Town County Post Code
Subject Work Tel. NI No if known
Date of Birth - dd/mm/yy //
3. Debt details Complete this section ONLY if instruction includes collection
Original balance £ Current balance £
Due Date - dd/mm/yy //
Reason for Debt
Please supply any additional information which may help us in our enquiries e.g. Fax no., email, etc. or anything else you feel is relevant.
I confirm that to the best of my knowledge the facts stated in this instruction are true. I understand that proceedings may be brought against me if I cause to be made a false statement in or concerning a document verified by me as true.*
If you are sending this instruction from outside the E.E.C., you must confirm that you have read the Data Protection section of our website and are familiar with the principles.