Debt Collection - Lodge a Debt

Request to Lodge a Debt

Please complete the form below to authorise The ARMS Group to act on your behalf in the specified matters.

If you are already a registered client of The ARMS Group please complete Part A and Part C only.

To: The ARMS GROUP

We hereby request The ARMS Group to act on our behalf, in accordance with the following details, to recover monies allegedly owing to us.

Part A - Registered Client Information

Please note fields marked with a red arrow indicates required information.

Client No:
Company:
Contact Name:
E-Mail:

Part B - Your Company Information

Address:			Contact:
Suburb or City:			Phone:
State (Province):			Fax:
Post (Zip) code:			Country:

Part C - Debtor Information

Business Name:			Contact:
Address:			Phone:
Suburb or City:			Fax:
State (Province):			E-Mail:
Post (Zip) code:			Country:
Period of Indebtedness - from date:			Amount Due:
to date:			Currency:

Please provide comments and other relevant details:

	Cheque dishonoured
	Account disputed
	Extreme procrastination
	Claims inability to pay
	Mail returned
	Phone disconnected

Please provide comments and other relevant details:

Comments:

Supporting Documents:

File 1:
File 2:
File 3:	Please note if your files are larger than 1mb please send them to us directly.

Please be patient if you have attached files.