Debt Placement Form - Legal Demand

 

Please fill in the form below, print the form and post it together with your cheque (or pay by bank transfer) to: Intrum Justitia, Legal Demand Service. The address is listed below right.

The price for this service is € 49.50, excl. 23% VAT. Please read our Terms and conditions.

Payment may be made by bank transfer; please email this form and proof of payment to: ie.newbusiness@ie.intrum.com

*The Legal demand letter will not be sent until payment is received. Please make your cheque out to Intrum Justitia.

Intrum Justitia – Bank details:
Bank: AIB
Branch: 7/12 Dame Street, Dublin 2
Account Name: Intrum Justitia Current Account
Sort Code: 93-20-86
Account Number: 85390-004
Your Details
Company Name
Date
Company Legal Status,
trading as
Contact Name(s)
Phone Number
E-mail
Address
Debtor Details
Debtor Name
Debtor Legal Status,
trading as
Address
Phone Number
Mobile
Fax Number
E-mail
Your Reference
Total Amount *
(please specify currency)
Oldest Invoice Date
*If this is made up of more than one
invoice, please provide details of all invoice dates,
numbers and amounts
Please detail actions you have already taken to date