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:
Credit Management Australasia Pty Ltd
PO Box Q1469
QVB Post Office
Sydney
NSW 1230
Australia


Client Authority to Act

Terms and Conditions

Instructions

Please fill out the electronic form on the
right, or alternatively you can download
the below PDF and post it to:
Credit Management Australasia Pty Ltd
PO Box Q1469
QVB Post Office
Sydney
NSW 1230
Australia


Debt Recovery Instruction

Terms and Conditions

Company Details
* Company Name:
* Trading As:
* Contact Name:
* Second Contact:
* Physical Address:
* Postal Address:
State:
* 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:

Are you an existing client?
  

Your Details
  
* Company Name:
* Contact Name:
* Phone:

Debtor Information
  
Company Name:
Name(s):
Surname:
Date of Birth:
Gender:
Trading As:
Contact Name:
Second Contact:
Registered Office:
Physical Address:
Postal Address:

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 AUSCML will take the most appropriate action with the information provided.





Verification
Enter the numbers you see above: