We are hereby authorised, pursuant to part 3 of the Tribunal Courts and Enforcement Act (TCEA 2007), Enforcement by Taking Control of Goods

Tenant / Company Name:*

Demise Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing Address: (if not same as demise address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Tenants Contact Name:*

First Last

Tenants Email:

Phone No:*

Mobile No:

Type of Business carried out:*

Opening Hours (if known):

Total amount to be Collected: £

For the total sum of: N.B; Only Rent, Interest + VAT are recoverable. - Being arrears of pure rent due to the landlord.

Rent:*

Interest:*

VAT:*

Total Outstanding:*

Name of Landlord:*

Is the Landlord VAT Registered:*

VAT Number:

The period in relation to which the rent is owed:

From:*

To:*

Rent Due:*

Is a commercial lease in place:*

Is tenant holding-over but not exceeding a period of 6 months:

Attached Information

Attached Information:

Invoice
Statement of Account
Additional Supportive Information

Photo / File / Site Plan upload:

Drop files here or

Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 16 MB.

Specify Tenancy:*

Please detail any additional information that might assist our collections agents whilst attempting to recover the outstanding debt:

Instructing Client Details

Client Name*

First Last

Client Company Name:

Client Contact Email:*

Client Tel:*

Client Mobile:

Client Remittance Details

Client Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Bank Remittance Details:*

Bank Name: Account Name: Account No: Sort Code: Reference:

Terms & Conditions

Authority is given to Collect My Debt Limited t/a CMD Enforcement (CMD) to exercise Enforcement by Taking Control of Goods as per the relevant legislation on this instruction. I confirm that I am submitting this document because I am the landlord or duly authorised by the landlord to act on their behalf. By completing and sending CMD this authority to enforce, I confirm that the debts are lawfully due and collectible under Enforcement by Taking Control of Goods. This shall be your sufficient authority and indemnification against all actions at law, as well as against all costs, charges or expenses that you may incur or be liable to pay by reason of your executing this enforcement. We hereby undertake to not hold you accountable for any goods forcibly or clandestinely removed. We also agree to refund CMD for any cheques, debt or credit card payments that are recalled by the bank or card merchant after you have paid funds over to us. We shall repay those funds to you immediately and deem that the rent to be still unpaid. We also agree for you to invoice for any lawful enforcement fees where a tenant pays us directly after enforcement has commenced if we do not wish you to proceed against the tenant.

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I agree to the Terms and Conditions

It is a condition of this instruction that all directors, shareholders and members of the Claimant Company (where applicable) personally guarantee Collect My Debt Limited's fees, costs and charges.

Review our Terms & Conditions

Signature:*

Please sign below to Instruct us and accept our Terms & Conditions - you can sign this using either a mobile / tablet touch screen or PC Mouse / laptop mouse pad

Date of Instruction

Email

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Protective Control of Goods

Total amount to be Collected: £

The period in relation to which the rent is owed:

Attached Information

Instructing Client Details

Client Remittance Details

Terms & Conditions

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