Contact us for a FREE Consultation:
08 9330 3095
Contact us for a FREE Consultation: 08 9330 3095
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New Client Form
New Client Form
Please fill out all relevant fields and accept the terms and conditions. We'll be in contact to confirm your details and start collecting your debts!
Client Name
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darrussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Name
*
First
Last
Mobile Number
Work Number
Fax
Email
*
Job Position
*
Terms and Conditions
Please read carefully and accept before continuing.
1) The client will instruct PB Investigations to pursue or issue a demand or cause process to be issued on its behalf at the
commission rates agreed on the attached Service Agreement.
2) By executing this agreement:
a) The client has briefed PB Investigations to pursue recovery of this debt;
b) The client will forthwith permanently cease the client’s own efforts pursuing recovery of the debt;
c) The client will not hinder PB Investigations own debt recovery efforts in respect of that debt.
d) The client irrevocably authorizes P.B Investigations to act as the client’s exclusive debt collection agents on the client’s
behalf for as long as the debt remains unpaid, and will render such assistance to PB Investigations as the latter may
reasonably require from time to time;
3) All expenses incurred by PB Investigations ancillary to its debt recovery with respect to Business and Company searches and
title searches are payable by the client to PB Investigations, and in addition to the abovementioned commission, PB
Investigations is entitled to charge the client an extra fee.
4) All solicitors’ costs incurred by PB Investigations on brief outs ancillary to its debt recovery, that the client authorizes, are
additionally to be paid or reimbursed by the client to PB Investigations.
5) The client authorizes PB Investigations to deduct its commission and all abovementioned extra fees and outlays from monies
PB Investigations recovers from the debtor. PB Investigations holds a first charge over the proceeds of recovery of the debt
that PB Investigations receives until PB Investigations receives its full entitlement.
6) If the client hereafter receives payment of the debt directly or indirectly from the debtor after signing this agreement, with or
without deductions, without the involvement of PB Investigations including goods and or merchandise returned for credit or
contra.
a) The client is still liable to pay to PB Investigations all of the latter’s outlays incidental to its debt recovery efforts, and all
the commission and other fees that PB Investigations would otherwise have been entitled to receive just as if PB
Investigations had itself recovered the debt, within 7 days from the date of such receipt by the client.
b) In default, interest of 5% p/month, calculated daily, will accrue to monies due but unpaid by the client to PB Investigations
under the last preceding subparagraph from the date PB Investigations ought to have received those monies from the
client, to the date PB Investigations actually receives those monies.
7) In the event that the client is a partnership, company or a trust, the contact person and his other partners, the company or the
trust are all jointly and severally responsible for ensuring that PB Investigations receives its due commission and entitlements
under this agreement.
8) P.B Investigations will endeavor to collect all recovery costs that are payable by the debtor in consequence of the debtor’s
default in paying the debt to the client only if there is a signed agreement between client and debtor which entitles the client to
the recovery of those costs.
9) The client agrees that PB Investigations is entitled to the above-mentioned entitlements in consideration of PB Investigations’
debt recovery efforts on behalf of the client.
10) PB Investigations shall not be liable for any damage or loss of any kind whatsoever and however arising caused incurred by
the negligence, of PB Investigations or any clerk, servant, workman, employee or agent of PB Investigations.
I hereby appoint PB Investigations as my agent with regard the collection of outstanding monies and matters relative thereto. I agree to be bound by the Service Agreement and Terms and Conditions (above) and further state that I am duly authorized to submit these documents
*
I accept the terms and conditions.
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