Questionnaire

So that we can assess whether we will be able to help you, please complete this questionnaire.

NOTE: All information will be kept confidential and will not be disclosed to any third parties.

What is the Name of the Company:

Your name: *

Your contact address: *

Your phone number: *

Email:

What is the Company Number:

List names and addresses of the Directors:

Name and address of the Company Secretary:

List names and addresses of the Shareholders:

What is the Company's business:

Location of Company:

Please include details of the amounts, contact details, reference numbers.

Details of pressing creditors:

Have you received demands or threats of Court action:

Yes No

If yes,from whom:

Have you received any County Court Judgements:

Yes No

Are there any Statutory Demands:

Yes No

Has anyone Distrained:

Yes No

If yes, whom:

Details of Company assets:

I confirm that I represent a UK company registered in the United Kingdom *

Please enter the following security code:

* Mandatory