CCJ PROCESSING INSTRUCTION FORM
Please return form to: High Court Collections Ltd., 9 Oaklands, Winchmore Hill, London N21 3DE
Email to admin@highcourtcollections.co.uk
Please pay the initial fee of £100.00 + VAT (at the current rate)
Cheques made payable to High Court Collections Ltd OR directly into the account:High Court Collections Client, Sort Code: 40-30-26, Account No: 51483358 Ref: “Debtor name”
Instructions for High Court Collections Ltd to take action
Our Ref:
Instruction from:
Contact Name:
Client Reference:
Company Name:
Address:
Postcode:
Email Address:
Telephone:
Claimant Details:
Landlord Name:
Address:
Postcode:
Email:
Telephone
Defendant Details:
Tenant Name:
Address:
Postcode:
Email:
Telephone
Details of the Debtor
Please tick ONE box only:
If known enter Registration No:
Limited Company / PLC / LLP
Enter details of debtor partners / individuals below if known
Firm / Partnership
Gender
Sole Trader (trading as)
Mr/Mrs/Etc.
First Name / Initials
M / F
Individual(s) without a business name or trading style
Other (Club, Charity, etc.)
High Court Collections Ltd
9 Oaklands, Winchmore Hill, London N21 3DE
T: 020 8144 9959 F: 0845 3700002 E: enquiries@highcourtcollections.com
Registered In England Number: 7887303 VAT Number: 137 5796 73
Surname
If not suing for Goods sold and delivered and / or Services rendered please tell us what the debt is for:
Invoice Details:
Invoice Date
Invoice No
GRAND TOTALS
Total Invoice
Amount
Amount Paid (if
Any)
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
Date Paid
Balance
Outstanding
£
£
£
£
£
£
£
£
£
If you have given any credit for any particular invoice, please confirm the balance of the invoice in the Total Invoice Amount Column
Brief Description of Goods or Services provided:
Case Details:
Amount Claimed: (£)
Your Reference (if applicable)
Currency
Date of Claim:
Additional Assessed Costs: (£)
Total Interest Account(£)
Total of Credits / Payments Received:
(£)
Additional Instructions including any information such as further addresses and details of any specific assets of the debtor
Tracing Services:
How Old is the information you have ? Do you require any Tracing Services ?
£45 plus VAT “no trace no fee” basis
Trace Only
Standard Trace & Asset Search
£75 plus VAT
Pre Sue Report
£150 plus VAT
[Please tick Service Required]
Yes
Yes
Yes
NOTES: (Please provide any other information that may assist in enforcement ?
Authorisation and Signature:
STATEMENT OF TRUTH AND HUMAN RIGHTS ACT 1998. To enable any Court Action to be issued it must contain a signed
Statement of Truth. Solicitors sign this on your behalf. The signing of the Statement of Truth is the statement to the
Court confirming your honest belief that the facts in this document are true. If for any reason the proceedings contain a
false statement then prosecution for contempt of Court may be brought against you, which may result in a fine or your
imprisonment. You must not instruct us on any matter involving the Human Rights Act 1998. This statement confirms
this.
I instruct High Court Collections Limited to issue Court Proceedings forthwith. I confirm that the Debtors Names and
Address are correctly stated and that the details I have given are accurate. I understand the consequences of this
Statement of Truth (Given above). I am unaware of any genuine dispute and know no reason why payment should not be
made.
I authorise High Court Collections Limited to instruct a third party in this matter and enforce a High Court Writ of Feiri Facias.
Print Name:
Date:
Please list any Attachments (if applicable):
Sign:
[Day / Month / Full Year]