Time limitation DEBT RECOVERY. Please bring completed Questionnaire and related documents with you during your first appointment

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1 EQUILAW Solicitors Ph: Market House 4 Market Street Muswellbrook NSW 2333 Fax: info@equilaw.com.au equilaw.com.au Date / / Next appt / / File no. Time limitation Locality Court 1. Creditor Details Conflict of interest check completed. DEBT RECOVERY Please bring completed Questionnaire and related documents with you during your first appointment Provide your details here. Title: Surname Given Names Occupation Postal address: (if differs) Daytime Phone: Facsimile: If Business: Company name Director s name/s ACN/ABN Existing Equilaw client 2. Debt Details Amount owed Date of supply Was there a contract for supply? Yes No If yes - Was It a written contract?c Yes No - Was it a verbal contract? Yes No Was a Credit Application in place? Yes No Were any guarantees made by company Directors? Yes No Is yes - provide a copy Provide copies of all related invoices page 1 of 5

2 3. Debtor - Provide as much information as you can. Title: Surname Given Names Occupation Postal address: (if differs) Daytime Phone: Facsimile: If Debtor is a Business: Company name Director s name/s ACN/ABN Debtor s Solicitor Firm Contact name DX Phone Facsimile Mobile Debtor s Current Employment If the Debtor is an individual provide as much information as you know about the debtor s current employment status I am not aware of Debtor s current employment status. Go to next question Self Employed Full Time Part Time Retired Casual Student/child Home Duties Not Working Other (provide details) Pensioner (provide details) Name of current employer/business Workplace address Business Ph page 2 of 5

3 3. Debtor - continued. Debtor s Bank Details I do not have the Debtor s bank details. Go to next question Bank Name Account Name BSB No. Account No. Debtor s Motor Vehicle Ownership Provide as much details you have of the Debtor s known main motor vehicle I do not know what vehicles the debtor has ownership of. Go to next question Registration number Make or model (e.g. Toyota Camry) Type (e.g. station wagon, sedan) Year of manufacture Colour page 3 of 5

4 5. Equine Debt Collection Complete this section if your enquiry is related to a horse/or multiple horses Is the horse or horses still in residence? Yes No Unsure Provide details Document Checklist Before attending your initial appointment, please ensure that you have attached copies of the following documents, if you have them. Identification (new clients only) Please bring along a source of identification, such as your drivers licence, Medicare card, Bank card, Centrelink ID, passport, birth certificate, or ASIC names index search. All invoices rendered Please provides a copy of all invoices rendered including interest charges; All agreements between yourself and the debtor Please provide a copy of any documents/ agreements signed by the debtor 7. Declaration Do you declare the information you have supplied is true and correct to the best of your knowledge and belief? Yes No Signature Dated How did you find out about Equilaw? Newspaper Radio Television Through friend or relative Agent referral Yellow Pages White Pages I am an existing client Internet Other page 4 of 5

5 OFFICE USE ONLY 8. The rest of this questionnaire to be completed by your solicitor and will be explained to you where applicable A. Local Court interest rates Under section 101 of the Civil Procedure Act 2005 interest is payable on the amount of the debt from the date of judgment until it is paid unless the Court otherwise orders. In respect to claims of $1,000 or more the court under section 100 may also order interest between the date that the cause of action arose and the date of judgment. Where the payment of interest is claimed prior to judgment the plaintiff must particularise the claim for interest in the statement of claim. The rate of interest is dealt with in the step-by-step guide; also refer to Local Court Practice Note 3 of B. Common counts Goods sold and delivered particulars of which have been provided to the defendant? Yes No Work done and materials provided particulars of which have been provided to the defendant? Yes No Moneys due and owing particulars of which have been provided to the defendant? Yes No Have we been given the particulars? NB: If a building claim, the contract must be in writing. Yes No C. Further details If claim is for quantum meruit - detail partial performance: Quantum meruit is a claim for what something is worth in relation to services If claim is for quantum valebat - detail goods or services supplied: Quantum valebat is a claim for what something is worth in relation to goods supplied Other comments/information: Division 5C of the Legal Profession Act A Solicitor must not provide legal services unless they reasonably believe, on the basis of provable facts and a reasonable view of the law, that a claim or defence has reasonable prospects of success in claims for damages. D. Costs Discussed costs? Yes No Estimate $ Forward costs agreement? Yes No Initial fees required? Yes No If Yes, $ page 5 of 5