CCJ representation Instruction

07824 593 876

info@businessdebtsolutions.co.uk

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Personal Details

Business Proprietor/Director *Please enter your full name

Business Name/Trading Name *Please enter the legal and full business trading name

Contact/Agent

Home Street/Road Address *

City/Town *

County

Postal Code *

Business Address

Please enter your full business address

Business Street/Road Address *

City/Town *

County

Postal Code *

Home Telephone *

Business Telephone *

Mobile *

Email Address *

CCJ Details

CCJ *

CCJ Number *

CCJ Issue Date *

Creditor *

Creditor Phone

Creditor Contact Name

Contact Position

Amount Outstanding *

GBP

Has the creditor instigated any external/3rd party recovery? *YesNo

Is there bailiff involvement? *YesNo

Please state why you require CCJ return and representation? *

Please provide your minimum offer amount as a full and final settlement.

GBP

Are you willing to offer payments towards the outstanding amount? *YesNo

Did you submit a response pack in your own defence? *YesNo

Was the CCJ issued against you in default/in your absence? *YesNo

Do you dispute any or all of the outstanding amount, is so please state why. *

Would you wish to continue to trade with the creditor upon satisfactory resolution? *YesNo

Do you have any other outstanding Judgements which could hinder the progress of this matter?

Authorisation

I {name-1} of {text-1} hereby nominate and authorise Business Debt Solutions to negotiate on behalf of the above company regarding the outstanding county court judgement detailed, outstanding to the above creditor.

Consent *

Yes, I agree to the authorisation as set out above.

Signed

Print *

Date *

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George Street
Haslingden
Blackburn
BB4 5RX

Tel: 07824 593 876