Collection assignment

  
 Creditor
Client number
  
Date
  
Company
  
Street and house number
  
Postcode
  
City
  
Country
  
Contact
  
Phone
  
Fax
  
Email
  
VAT numberr
  
 Debiteur
Company
  
Street and house numberr
  
Postcode
  
city
  
Country
  
Contact
  
Phone
  
Fax
  
Email
  
VAT number
  
Invoices
Invoice Nos
Invoice Date
Currency
Amount
Already paid
To be paid
 
Number of pages enclosed
   Remarks  
We would ask you to enclose a statement of account and a copy of the invoices, together with any correspondence, a copy of any uncovered cheques and contested bills of exchange and a copy of the proof of sending by registered mail.
In the interests of efficiency, the creditor shall notify ICS immediately of any action by the debtor, such as full or partial payment, contact or correspondence. Commission is payable in the following cases:  - upon payment to the client or to ICS  - in the event of an agreement to remit a claim or a setoff with the debtor. - if the creditor takes back the goods delivered.		  
Creditor signature:
Druk op "Versturen" om uw opdracht on-line door te geven. Wij sturen u de opdracht ter ondertekening
 
Click the printer icon to print this page and fax to +32-3-542.33.17
or Click the printer icon twice to print two copies of this page and send both copies to us. We will sign and return one copy
 
Don’t hesitate to contact us if you have any questions or require any additional information.
International Collection Services NV
Noorderlaan, 98 - b29
2030 Antwerpen		 Tel +32-3-542.31.53 - Fax +32-3-542.33.17
Email: info@icservices.be
BTW BE-0436.209.493 - RPR Antwerpen