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Placing accounts

Placing accounts


PLEASE FILL OUT THE FORM IN ORDER TO PLACE YOUR ACCOUNT


Note that the asterisk (*) fields are mandatory  
Creditor's company / name:*
Creditor's address:*
Postal code, city:*
Tax id number:*
Contact person:*
Creditor's email address:*
Creditor's phone / fax:*
Debtor's company / name:*
Debtor's address:*
Debtor's country:*
Debtor's tax id.no.:
Amount due / main claim:*
Currency:*
Basis of the debt (invoices etc.):
Debtor's phone:*
Debtor's fax:
Debtor's email address:
Additional info:
Second placed account? (NO/YES):*
Previous collection result:
How many agencies tried to collect the account:
Kod z obrazka:
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