Debtor/Creditor Registration Form

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

Company/Debtor Name * :
Debtor's Name is required

Contact Name :

Physical Address :

Postal Address :

Work Address :

Phone Biz :
Invalid Business Phone

Phone Mob :
Invalid Mobile Phone

Phone a/h :
Invalid A/H Phone

Email :

Company Name * :
Company Name is required

Contact Name :

Postal Address :

Phone :

Fax :

Email :

Cheques made payable to :

Goods or services supplied :

Your reference :

Amount outstanding :

Date incurred :
Dispute?

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 TERMS&COND SECTION OF THIS WEBSITE.

Comments / Special Instructions :

I HAVE READ AND AGREED TO THE TERMS AND CONDITIONS