Load Commercial Debt


Load Commercial Debt

Fields marked * are mandatory fields

If you have trouble with this online form you can request a manual form at admin@cia.nz

YOUR DETAILS

Company Name*
Trading As
Contact Person*
Contact Email*
Address*
Email for Statements
Phone
Mobile*
Bank Account Number* illion Tenancy
 -    -    -     
Your Reference illion Tenancy


 

DEBTOR DETAILS

Company Name*
Trading As
Company Email 
Company Website Address
Company Phone 
Company Social Media Profile
Current Company Address 
Contact Person 
Contact Person's Position
Contact Person's Phone
Contact Person's Email
Other information on this debtor that may help with collecting the debt?

Upload Photo of Debtor



 

DEBT DETAILS

Amount Owing $*
Invoice / PO Number(s)*
Date incurred / Invoice Date*  (use format DD/MM/YYYY)
Do your terms of trade have a collection provision?* illion Tenancy
Reason Debt / Dispute*
Upload Copy of Unpaid Invoice(s)
Upload Other Supporting Documents
Previous Civil Enforcement Proceedings*  

Court policy requires you to confirm CIA Debt Recovery will be your debt collection agent acting on your behalf.

Download and sign this Authorisation to Act on Behalf form*  


Upload your signed Authorisation to Act on Behalf form*

Please chose your debt collection Pricing Option*
  View Pricing Options

I have read and understood CIA Debt Recovery's full Terms of Engagement*  

By accepting these terms, you agree to authorise CIA Debt Recovery Ltd to act as your agent in the above matters and agree to make payment of all charges and costs in accordance with the Terms of Engagement.

You agree to not proceed to legal action, nor take independent action by another means through an agency or, on your own accord, against this debtor without first consulting CIA Debt Recovery Ltd. 

If you do take independent action or/and if any monies are paid to you or your agent, by the debtor, CIA Debt Recovery Ltd will invoice you for the full commission that relates to the option you have chosen above and any subsequent enforcement costs.


How did you hear about us?

If you have trouble with this online form you can download the PDF form here and send the completed form to admin@cia.nz