Online request2017-06-27T01:04:59+00:00

Online request

You can send us any debt collection requests by filling out the below request!

Your company details

Are you currently a customer?
Yes, I am a customerNo, I am not a current customer

Costumer ID

Customer Name (required field)

Address (required field)

Telephone (required field)

Fax

E-Mail (required field)

Debtor

Company name (required field)

Address (required field)

Telephone

E-Mail

Customer ID / Invoice No.

Date of invoice

Invoice due date

Type of debt (required field)

Invoice balance

Details

Request

I request for the transfer of funds owed to the following account:

Bank

IBAN

BIC

Date

In order for us to efficiently fulfil your request please send us a copy of the invoice via fax to +43/(0)662/875346-22 or email auftrag@COMMERZ-inkasso.at.

I have read and understood the terms and conditions (AGBs) and hereby give COMMERZ Inkasso the authority to act on my behalf regarding the above mentioned invoice and subsequent debt.