Recover a Debt

Client Name*

Your Name*

Job Position*

Client Email*

Submit a single debt for collection

To submit a single debt for collection, please fill out the following form:

Person or Company Name*

ABN/ACN

Debtors Current Address

I don't know the current address of the debtor.

(if known)

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Debtor Email

Mobile

Home Phone

Work Phone

Place of Work Details

Date of Birth

Details of relatives or friends if known.

Debt Details

What is the debt for?

Amount Outstanding*

Commission Rate on Recovery

Our standard commission rate is 25% on recovery unless you have prenegotiated an alternate rate. To discuss, call PB Investigations and advise us on your situation. Direct mobile: 0412 936 123

Attach a copy of invoice (if available)

Date of Debt

Does the debtor have a contract/agreement that states they are liable to pay collection costs?

No
Yes (please attach a copy of the contract/agreement).

File

Any other information that may be useful

If the client is pursuing a debt owed to the client's trading entity, the client commits both the client and the trading entity to be jointly and serverally responsible for payment of PB Investigation's commission.

*

I accept the terms and conditions* (if completing by computer)

Instruction To Recover Debt

Existing Customers.