Pacific Mercantile - Debt Collector

Collection Instructions to:
Pacific Mercantile Pty Ltd
ACN: 011 004 596
ABN 49 011 004 596


Townsville:
Level 1, 41 Denham Street
Townsville Queensland 4810
Postal address
PO Box 865, Townsville Q 4810

Telephone: (07) 3016 3237
Facsimile: 1800 181 774
E-mail: pacmerc@pacificmercantile.com.au

 Brisbane
Level 2, 293 Queen Street
Brisbane Queensland 4001
Postal address
GPO Box 198, Brisbane Q 4001

Telephone: (07) 3016 3237
Facsimile: 1800 181 774
E-mail: pacmerc@pacificmercantile.com.au

COLLECTION INFORMATION REQUEST
FOR NEW CLIENTS.

Debtors Information:
 
Debtor 1
Debtor 2
Debtor's name in full:
Address (City, State, Postcode)
Telephone
Transaction in brief
Date of Debt
Amount

Debtors Information:
 
Debtor 3
Debtor 4
Debtor's name in full:
Address (City, State, Postcode)
Telephone
Transaction in brief
Date of Debt
Amount
Clients Information:
Acceptance

accept the attached Proposal for Debt Collection, and agree to be bound by the Terms and Conditions of Debt Collection, as stated above.

Date
    
Name of Company
ABN
Address
Postcode
Phone
Fax
Email
 
Name
Position
Further Details: