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Instruction for Collection

To Invoice Discounting Operations HSBC Invoice Finance (UK) Ltd Cannon House 23-29 Chatsworth Road Worthing BN11 1NA

BN11 1 uwave NA

From

Client name*

Client number*

Please complete all the mandatory boxes on the form (marked with*) and attach all the required documentation in order for us to process the claim effectively. Please sign and return to ifc.mail@hsbc.com.

References

___

Customer registered name*

Customer account number*

Trading name* (if different)

____

Customer VAT number ___

Customer contact name* Customer tel. number*

Customer mobile number ___

Balance outstanding* ___

Customer trading terms*

Customer reg. number (if Limited company)*

Customer email address*

Customer address*

Please take responsibility for collection of this debt. We understand that our agency arrangement to collect the debt has ended and further collection activity may involve legal proceedings. We confirm that, for the purpose of any such proceedings, the information and the documentation supplied is true and accurate. We also confirm that we have given notice to the above customer that all unpaid debts owing by it have been assigned to you.

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We acknowledge that if this Instruction for Collection has not been received by you within the timeframe specified in your Credit Protection Policy (60 days past the due date of the oldest invoice or 120 days past the oldest invoice date, whichever is the soonest) then this may delay or invalidate any Credit Protection Payment due.

We acknowledge that if this Instruction for Collection has any of the following documents missing or incomplete, then any Credit Protection payment due may be delayed or invalidated.

All of the following documents are attached

Customer Statement

Copy Orders and any Sales Acknowledgements

Copy Invoices and Credit Notes, if any, covering the full outstanding debt

Signed Delivery Notes/Timesheets or other Proof of Contract Completion

Copy of Final Demand Letter and Assignment Notice

Collections Activity Notes

Copies of any relevant correspondence with the customer and contractual terms and conditions

Details of any disputes

We also confirm that an account has been opened for the above customer online.

Please select:

We can confirm that we have Retention of Title rights (ROT) under the contract of sale to recover goods delivered to the customer which are unsold and not paid for.

We can confirm that we do not have Retention of Title rights (ROT) under the contract of sale to recover goods delivered to the customer which are unsold and not paid for.

We also confirm that:

If, within 5 working days, we have not received a confirmation message electronically acknowledging receipt of this instruction, we will contact our appointed client controller.

We will not send out any further statements and should we receive any subsequent payments, returned goods or correspondence from the customer, we will refer it to you immediately.

We are aware that if the account is passed to your Solicitors, we can view progress of the case electronically.

Signature:

Date: D D M M Y Y Y Y