Debt Collection Specialists | Sydney | LCollect
Debt Collection Agency | LCollect

Arrangement


Please complete the form below to enter into an arrangement to repay your debt. We are required to verify your identity so please ensure you complete as many personal details as possible.

We recommend that this form be completed at a desktop computer using Internet Explorer, Google Chrome or Mozilla Firefox.

Once you submit this form you will receive an automated email notification that you request has been received.

We will be in contact by your preferred contact method if we require any additional information or to discuss your proposal further.

If you would like to update your details please click here or for details on how to make a payment towards your debt click here.


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* Mandatory Field
 

YOUR PERSONAL DETAILS


 
 

 

 

 

 

 
   
 

YOUR EMPLOYMENT DETAILS


 

 
 
 

YOUR HOUSEHOLD INCOME



 

 

 
 

 
 

YOUR REGULAR EXPENDITURE



 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 

DETAILS OF YOUR ASSETS

 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 
 

DETAILS OF YOUR OUTSTANDING DEBTS

 

 
 

 
 

 
 

 
 

 
 
 
 

YOUR REPAYMENT OFFER

 

 
 

 
 

 
 

ATTACH SUPPORTING DOCUMENTATION


 
 

VERIFICATION STATEMENT



   
   
   
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