Client Authority To Act

Debt Recovery Instruction

Instructions

Please fill out the electronic form on the
right, or alternatively you can download
the below PDF and post it to:
NZ Credit Management
PO Box 106087 Auckland City 1143

Instructions

Please fill out the electronic form on the
right, or alternatively you can download
the below PDF and post it to:
NZ Credit Management
PO Box 106087 Auckland City 1143

Company Details

* Company Name:
* Trading As:
* Contact Name:
* Second Contact:
* Physical Address:
* Postal Address:
* Phone:
Fax:
Mobile:
* Email Address:
* Company Number:
* REGN Date:
* Type of Business:
* Limited Liability (please tick):  
* Bank Account Details:

Accountant

* Accountant:
* Contact Name:
* Phone:
Fax:

Solicitor

* Solicitor:
* Contact Name:
* Phone:
Fax:

Authorised by

* Name:
* Position:

Verification

Enter the numbers you see above:

Terms

Are you an existing client?

  

Your Details

  
* Company Name:
* Contact Name:
* Phone:

Debtor Information

Name(s):
Surname:
Date of Birth:
Gender:
Trading As:
Physical Address(es):
Postal Address(es):
Last Known Phone:
Last Known Mobile:
Last Known Work Phone:
Last Known Fax:
Website:
Email:
Vehicle Information - Make/Model:
Registration:
Colour:
Other Details:

Next of kin information

Name(s):
Surname:
Gender:
Employer:
Last Known Address(es):
* Amount of Debt:
* Date of Debt:
* Debt Description:
* Proof of Debt:


Attachment:
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If no specific instructions are indicated below, the client acknowledges that NZCML will take the most appropriate action with the information provided.





Verification

Enter the numbers you see above:

Terms