ADVICE OF OUTSTANDING DEBTS
Please complete the form if you wish to instruct us or discuss a single debt. If you wish to discuss your debts and commission rates, please go to "contact us" for telephone, fax and e.mail details.
Client Name: |
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Address: |
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Post Code: |
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Tel No: |
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Fax No: |
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e.mail address: |
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Contact Name: |
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Job Title: |
NO SUCCESS - NO FEE COLLECTION SERVICES
10% commission on debts up to 6 months old - 20% Commission on all older items
These rates apply for debt values from £500 to £10,000 for UK debt collection (inc. N. Ireland). For debts outside the UK or under £500 in UK, an additional 5% commission will be charged. Rates are negotiable for debts over £10,000.
Details of the debt you want collected:
Debtors Trading Name: |
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Contact Name |
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Title (Mr/Mrs/Miss/Ms) |
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Oldest Invoice Date: |
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Number of invoices: |
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Total Debt value: |
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Please confirm the currency if it is not Sterling: |
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Debt disputed? |
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Debtors Address: |
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Post/Zip Code: |
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Tel No: |
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Fax No: |
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e.mail address (if known): |
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Details of recovery actions carried out to date: |
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Any Additional Information that may help Capitol in their collection procedures: |
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By submitting this completed form you are agreeing to pay commission at our stated rates for successful recovery, as set out on the page "commission rates" and that you have had the opportunity to read our Terms & Conditions. |
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In addition, you are agreeing that the debt submitted is a valid, legally incurred debt and that you are the correct beneficiary of any money we recover. |
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You are hereby giving us permission to receive money on your behalf should the debtor send the money to us. All monies received will be held in a Client Account on your behalf and sent to you after deduction of our commission and sales tax (applicable if you are an EU country). |
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Please accept this as our authority to act on our behalf, we have read and understood the above items. |
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