STEP 2
Debtors title
Mr
Mrs
Ms
Miss
Dr
Other or Unknown Title
Debtors first name
Debtors last name
Debtors company name (if applicable)
Debtors business address (if applic)
Debtors business city/county (if applic)
Debtors business postcode/zip (if applic)
Debtors country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegowina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, the Democratic Republic of the
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia (Hrvatska)
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
France Metropolitan
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and Mc Donald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao, People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia (Slovak Republic)
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Pierre and Miquelon
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania, United Republic of
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zambia
Zimbabwe
Debtors business tel (if applic.)
Debtors home address (if applic.)
Debtors home city/county (if applic.)
Debtors home postcode/zip (if applic)
Debtors home country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegowina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, the Democratic Republic of the
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia (Hrvatska)
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
France Metropolitan
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and Mc Donald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao, People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia (Slovak Republic)
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Pierre and Miquelon
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania, United Republic of
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zambia
Zimbabwe
Debtors home telephone (if applic.)
Debtors email address (if applic.)
Total amount of debt (exact amount)
In what currency is your debt?
United Kingdom Pounds - GBP
United States Dollars - USD
Afghanistan Afghanis - AFN
Albania Leke - ALL
Algeria Dinars - DZD
Argentina Pesos - ARS
Australia Dollars - AUD
Austria Schillings - ATS
Bahamas Dollars - BSD
Bahrain Dinars - BHD
Bangladesh Taka - BDT
Barbados Dollars - BBD
Belgium Francs - BEF
Bermuda Dollars - BMD
Brazil Reais - BRL
Bulgaria Leva - BGN
Canada Dollars - CAD
CFA BCEAO Francs - XOF
CFA BEAC Francs - XAF
Chile Pesos - CLP
China Yuan Renminbi - CNY
RMB (China Yuan Renminbi) - CNY
Colombia Pesos - COP
CFP Francs - XPF
Costa Rica Colones - CRC
Croatia Kuna - HRK
Cyprus Pounds - CYP
Czech Republic Koruny - CZK
Denmark Kroner - DKK
Deutsche (Germany) Marks - DEM
Dominican Republic Pesos - DOP
Dutch (Netherlands) Guilders - NLG
Eastern Caribbean Dollars - XCD
Egypt Pounds - EGP
Estonia Krooni - EEK
Euro - EUR
Fiji Dollars - FJD
Finland Markkaa - FIM
France Francs - FRF*
Germany Deutsche Marks - DEM
Gold Ounces - XAU
Greece Drachmae - GRD
Guatemalan Quetzal - GTQ
Holland (Netherlands) Guilders - NLG
Hong Kong Dollars - HKD
Hungary Forint - HUF
Iceland Kronur - ISK
IMF Special Drawing Right - XDR
India Rupees - INR
Indonesia Rupiahs - IDR
Iran Rials - IRR
Iraq Dinars - IQD
Ireland Pounds - IEP*
Israel New Shekels - ILS
Italy Lire - ITL*
Jamaica Dollars - JMD
Japan Yen - JPY
Jordan Dinars - JOD
Kenya Shillings - KES
Korea (South) Won - KRW
Kuwait Dinars - KWD
Lebanon Pounds - LBP
Luxembourg Francs - LUF
Malaysia Ringgits - MYR
Malta Liri - MTL
Mauritius Rupees - MUR
Mexico Pesos - MXN
Morocco Dirhams - MAD
Netherlands Guilders - NLG
New Zealand Dollars - NZD
Norway Kroner - NOK
Oman Rials - OMR
Pakistan Rupees - PKR
Palladium Ounces - XPD
Peru Nuevos Soles - PEN
Philippines Pesos - PHP
Platinum Ounces - XPT
Poland Zlotych - PLN
Portugal Escudos - PTE
Qatar Riyals - QAR
Romania New Lei - RON
Romania Lei - ROL
Russia Rubles - RUB
Saudi Arabia Riyals - SAR
Silver Ounces - XAG
Singapore Dollars - SGD
Slovakia Koruny - SKK
Slovenia Tolars - SIT
South Africa Rand - ZAR
South Korea Won - KRW
Spain Pesetas - ESP
Special Drawing Rights (IMF) - XDR
Sri Lanka Rupees - LKR
Sudan Dinars - SDD
Sweden Kronor - SEK
Switzerland Francs - CHF
Taiwan New Dollars - TWD
Thailand Baht - THB
Trinidad and Tobago Dollars - TTD
Tunisia Dinars - TND
Turkey New Lira - TRY
United Arab Emirates Dirhams - AED
Venezuela Bolivares - VEB
Vietnam Dong - VND
Zambia Kwacha - ZMK
Date debt incurred (or date of oldest unpaid invoice).
- choose -
January
February
March
April
May
June
July
August
September
October
November
December
- choose -
2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 Pre 2010
Tick as many as required.
Unpaid invoice/s
Dishonored written contract/s
Dishonored verbal contract/s
Dishonored cheques
Debt status.
Debtor delaying or avoiding
Disputing the whole debt
Disputing some of the debt
Is the debtor still at the address above?
Debtor is definitely still there
Debtor may have moved
Debtor has definitely moved away
Has another agency/solicitor ever attempted to recover this debt?
Yes
No
Have you already obtained a Court Judgement on this debt.
Yes
No
Court name and reference number. (if applic.)
Please tell us what this debt is for.
Please include any other notes that
might help with recovery.
I have read and agree to our Terms & Conditions
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