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Client hereby passes on the above claim for collection and declares to have taken cognizance of the General Terms and Conditions of Deurwaarderhelmond Bailiffs and Debt-Collection Specialists, which terms and conditions are published at this site and will also be sent to client upon request. Said terms and conditions are applicable to this order.



Details of the debt:
Invoice number (s) / Date  / Amount
Amount paid & Date
Terms and Conditions of Delivery
If availale, attach copy
Please attach the following documents:
If you have any other documents, please send them over by e-mail, regular mail or fax

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Details client:


Details debtor:


s.v.p. alle specificaties, nota’s, voorwaarden en correspondentie zo spoedig mogelijk per post (postbus 229, 5700 AE Helmond) per fax (0492 523732) of per email (info@deurwaarderhelmond.nl) opsturen.

Indien er bij u verhaalsmogelijkheden (bankgegevens, roerende- of onroerende zaken) bekend zijn, deze graag vermelden.