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Collection Instruction Form

Please use the form below to provide information on collection request.
Alternatively feel free to print and fax this copy.

All information is confidentual and not discolosed to any other source.

click to print or email collection instruction form.

   YOUR DETAILS   
Client Name:*
Client Address:*
Contact:
Phone:*
Email:*
  We the client authorise Link Receivables Ltd to proceed on the below debt at the agreed contract rate.  We acknowledge and agree to the terms and conditions overleaf.
*Required fields  
  DEBTOR'S DETAILS    (Fields are not compulsory, please complete as much as possible)
Debtors Full Known Name:  

Trading Name:
(if applicable)

 
Debtors Legal Entity: Individual   Sole Trader    Partnership     Ltd company
Debtors Physical Address:  
Debtors Postal Address:
(if different to above)
 
Phone Private:  
Phone Work:  
Fax:  
Cellphone:  
Email:  
Employer:
(name and address)
 
Next of Kin:
(name and address)
 
Debtor Contact Name:
(if business)
 
Date of Birth:  
Occupation:  
Date(s) of Debt:  From
 To
Debt Amount:  
Your Ref:  
Description of Debt:  
Did debtor sign a credit account application form, order form or personal guarantee?
  Yes  No
Is interest recoverable? Yes  Rate:
No
If required, are the following available? Order Forms
Invoices
Delivery Dockets
Special Instructions:  
 

Terms and Conditions

THE INSTRUCTION FORM OVERLEAF INCORPORATES THESE TERMS AND CONDITIONS.  THIS FORM AND THESE TERMS AND CONDITIONS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN US, UNLESS THERE IS A SEPARATE AGREEMENT BETWEEN US GOVERNING OUR SERVICES TO YOU, IN WHICH CASE THE TERMS AND CONDITIONS OF THAT AGREEMENT, WHERE DIFFERENT WITH THESE TERMS AND CONDITIONS, SHALL APPLY.

1. DEFINITIONS
1.1 “We”, “us” and “our” mean Link Receivables Ltd.
 “You” and “your” mean the Client.
 “Service” and “Services” include Link Receivables Ltd’s debt collection, credit information, repossession and associated services requested by you from time to time.

2. APPOINTMENT OF LINK RECEIVABLES LTD
2.1 You appoint us to act as your agent to provide the Services in accordance with these terms and conditions, and we accept the appointment.

3. OUR OBLIGATIONS
3.1 We will provide the Services requested promptly and report to you on progress as requested by you.
3.2 Where necessary, we may instruct third parties (including solicitors) to assist us in providing the Services.
3.3 We will not compromise, secure, or settle any debt for less than the outstanding balance without your authority unless in the circumstances it is not reasonably practicable to obtain your authority.
3.4 If money we collect on your behalf is not passed directly to you, we will hold it in your trust account or the trust account, and we will account to you on a monthly basis.  We may deduct any money you owe to us prior to forwarding any funds to you.  You acknowledge that our cheque to you may be based on uncleared funds and you agree that if any such funds are dishonoured, you will immediately refund the amount of our cheque to us upon request.

4. YOUR OBLIGATIONS
4.1 You will give us clear written instruction in respect of each Service requested.
4.2 When you issue any instruction for the performance of a Service, you will also provide us with all relevant information, materials and documentation you have in your possession concerning that instruction.
4.3 You will inform us immediately if you become aware of any change to any information you have provided to us.
4.4 You will immediate notify us of any payment paid direct to you or any other reduction of a debt.
4.5 No arrangement will be made between you or the debtor without first notifying Link Receivables Ltd to ascertain any existing arrangement or special circumstances relating to the debtor.

5. PAYMENT OF OUR COMMISSION, FEES AND DISBURSEMENTS
5.1 You will pay our commission, disbursements, fees and other charges at our rates as set and/or agree from time to time, and will in addition pay to us any GST payable in accordance with the Goods and Services Tax Act 1983 in respect of goods and services provided by us.
5.2 Commission is payable on any payment by or on behalf of a debtor, or on any credit raised, goods returned or contra issued by you or in settlement or reduction of a debt.
5.3 You will pay our invoices by the 20th day of the month following the date of invoice.  We may at our discretion charge interest on any amount overdue at the rate of 2% per month, compounding monthly.  You will be liable to us for all costs we incur as a result of your failure to pay on time, including cost of collection costs and the costs of legal action including lawyers’ costs on a solicitor-client basis.
5.4 If you withdraw any debt or service instruction:
 (a) we may hold each file affected until we receive payment in full of all amounts you owe us; and
 (b) we may charge out our usual “Closed File” fee on each file affected and, on each debt instruction affected may also charge a withdrawal fee of up to 5% of the outstanding balance excluding disbursements.

6. INDEMNITIES AND EXCLUSION OF LIABILITY/ACCURACY OF INFORMATION
6.1 We will not be liable to you for any liability, loss, damage, cost or claim arsing from or in connection with any Service provided by us to you.  You agree to indemnify us against any actions, liabilities, charges, demands, expenses, losses, damage claims or costs incurred by us as a result of acting upon any instruction from you or arising from any information or lack of information supplied by you, or your breach of any of these terms and conditions.
6.2 We take no responsibility for the correctness or accuracy of any information we supply to you and we shall not be liable to you for any liability, loss, damage, cost or claim arising from reliance on or use made of that information, however caused.

7. PRIVACY ACT – DEBTORS
7.1 You confirm to us that our use of any information you provide us concerning that individual is one of the purposes or is directly related to the purposes in connection with which the information was obtained from that individual.
7.2 The provision of any information, materials or documentation by you to us constitutes confirmation by you to us that the information, materials or documentation have been obtained by you in accordance with the Privacy Act 1988, including but not limited to you having disclosed to the individual concerned the purposes of collecting the information, any intended recipients of that information, and the right of the individual to access and correct any information.
7.3 You confirm that the individual has authorised any person, corporation or organisation to provide you and us with the information we may require in response to any enquiries we make in carrying out any instruction from you.

8. PRIVACY ACT – YOU (IF YOU ARE AN INDIVIDUAL)
8.1 Where the Client is an individual:
 (a) you acknowledge that any personal information you supply to us is supplied for all purposes relating to our performance of our Services, including but not limited to collecting any debt you owe us, the listing with any credit reporting agency of any debt you owe us, and also for our marketing purposes.  You hereby authorise us to supply any such information to third parties for these purposes or any related purposes;
 (b) you acknowledge that you are aware of your right to access and correct any personal information we hold about you;
 (c) you authorise us to undertake a credit check or credit checks on you at any time by any means whatsoever.

 


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Contact Us

T. (03) 339 6438
F: (03) 339 6439
E: info@linkreceivables.co.nz

PO Box 37301
Christchurch