Debtor / Creditor Registration Form

Thank you for choosing Auckland District Collections Limited. Please find following our DEBTOR / CREDITOR registration form for your completion.
Please ensure that information provided is as accurate as possible.

Debtor's details

  

Creditor's (your) details
Company/debtor name *     Company name *  
Contact name     Contact name  
Physical address     Postal address  
Postal address     Phone  
Work address     Fax  
Phone   biz
  mob
  a/h 		  Email *  
Email     Cheques made payable to  
         
Goods or services supplied        
Your reference        
Amount outstanding        
Date incurred      
Comments /
special instructions 		   
         

IN SUBMITTING THIS FORM I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND AGREE TO AUCKLAND DISTRICT COLLECTIONS LIMITED'S TERMS AND CONDITIONS OF TRADE AS DETAILED WITHIN THE SERVICES SECTION OF THIS WEBSITE.

      
* Terms and Conditions
 

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