Load Tenancy Debt


Load Tenancy Debt

Fields marked * are mandatory fields

YOUR DETAILS
Company Name
 		Trading As
Full Name*
 Email*
Address*
Mobile* Landline
Bank Account Number* illion Tenancy
 -    -    -      		Email for Statements*


 

DEBTOR DETAILS
First Name*
 		Last Name*
Middle Name(s) 
 		Gender *
Date of Birth illion Tenancy
 		Email
Mobile
 Alternative Phone 
Debtor's Current Address 
Occupation 
 		Employer
Employer's Phone
 Employer's Email
On WINZ Benefit? *  illion Tenancy
 		WINZ Number illion Tenancy
Other details that may help with collecting the debt?

Upload Photo of Debtor

DEBTOR 2 DETAILS
First Name*
 		Last Name*
Middle Name(s) 
 		Gender *
Date of Birth illion Tenancy
 		Email
Mobile
 Alternative Phone 
Debtor's Current Address 
Occupation 
 		Employer
Employer's Phone
 Employer's Email
On WINZ Benefit? *  illion Tenancy
 		WINZ Number illion Tenancy
Other details that may help with collecting the debt?

Upload Photo of Debtor

DEBTOR 3 DETAILS
First Name*
 		Last Name*
Middle Name(s) 
 		Gender *
Date of Birth illion Tenancy
 		Email
Mobile
 Alternative Phone 
Debtor's Current Address 
Occupation 
 		Employer
Employer's Phone
 Employer's Email
On WINZ Benefit? *  illion Tenancy
 		WINZ Number illion Tenancy
Other details that may help with collecting the debt?

Upload Photo of Debtor



 


DEBT DETAILS
Tribunal/Mediators Order Amount $* 
 Amount Already Paid By Debtor $*
Amount Owing $*  (This field will be automatically calculated)
 Tenancy/Mediators Tribunal At
  
Tenancy Address*
Tribunal/Mediators Order Number*
 Tribunal/Mediators Order Sealed Date*
Upload Copy of Tribunal/Mediators Order
 Upload Other Supporting Document
Your Debt Reference illion Tenancy


 

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DEBT COLLECTION AGREEMENT

Choose a debt collection Pricing Option



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 

Upload your signed Authorisation to Act on Behalf form 
Terms of Engagement

By accepting these terms, you agree to authorize 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 debts@cia.nz
 

© Copyright 2026 CIA Debt Recovery Ltd, all rights reserved.

 


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