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Debtor trading name *
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Debtor contact name(s)
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Debtor address *
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Debtor trading style
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Debtor company number or private address
If a Limited Company, enter company registration number; if not, enter private address (if known)
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Debtor telephone number(s) *
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Debtor mobile number(s)
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Debtor fax number
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Debtor email address(s)
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Dates of delivery and/or invoice numbers
(if more than 10, state VARIOUS)
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Currency
(indicate if other than sterling)
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Amount of claim *
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Interest 
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Collection or compensation charges
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Total
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How was the debt incurred?
e.g. Goods delivered. Services rendered
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Other information
(Please enter any additional details)
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Supporting documentation
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Attach relevant documents, such as invoices, here. If you have more than 3 documents, please ZIP them up, and attach the ZIP file instead.
The total size of your attached files must not exceed 2Mb (2048Kb). To arrange bulk data transfer, please contact us.
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document 1 of 3
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document 2 of 3
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document 3 of 3
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Your company name *
(If your demand is in the name of a subsidiary, enter that name and address)
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Your name *
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Your telephone number *
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Your email address *
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PLEASE ENSURE THAT YOU REGISTER AS A NEW CLIENT PRIOR TO SENDING YOUR INSTRUCTION.
You only need to register once. You can then send instructions at any time.
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* = required field
Please Note. Once submitted you will return to this screen.
Note: By submitting this form, you acknowledge your acceptance of LPL Commercial Investigations' Terms and Conditions .
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