The Insolvency Service 
Investigations and Enforcement Services Breach Questionnaire
Use this form if you wish to report:
  • a disqualified director who is breaching a disqualification order
    •  
  • an individual breaching bankruptcy or debt relief restrictions
    •  
  • a company/ business re-using a prohibited name
Before you complete this form please read the following to find out what we do and other useful information:

For breaches of restrictions or a disqualification order

For companies / businesses re-using a company name

Please provide as much of the information asked for as you can, as this will give us the best start to considering your complaint and where we might go for further information. We appreciate that you may not be able to provide all the information requested, but any information you give will greatly help any enquiries that may be undertaken into your allegations.
Details
Name of bankrupt / disqualified director / person complained of *
Name & address of company he / she is involved with (if applicable)
Name (forename/surname)
Address
 
 
 
 
Postcode
 
Is the above named company still trading?
Are you are giving the following information on behalf of a partnership or company?

If YES, please complete the following
Business name
 
 
Type of Business (e.g. company/partnership)
Your position in the business (e.g. director/partner/manager)
Business address (if different from above)
Address
 
 
 
 
Postcode
 

Are you, the partnership or your company owed any money by the company in which the (bankrupt / disqualified) director is involved?
If YES, how much?
 
How long has the debt been outstanding?
 
Were any references given when the account was opened?
Were any representations made by the bankrupt / disqualified director in order to obtain credit, either by writing or verbally?
 
If either you, your partnership or your company are not a creditor, how has information that an undischarged bankrupt/disqualified individual is involved in the management of
a limited company been brought to your attention?
 
 
What are your reasons for believing that the individual has taken part in the company's management or otherwise directed its affairs?
 

Are you in possession of any letters or other documents signed by or on behalf of the bankrupt/disqualified individual in connection with the company's affairs?

Are you aware of any other persons who can support what you have to say? If yes please supply their details
Name (forename/surname)
Address
 
 
 
 
Postcode
 

About you
Please provide your full name and address, telephone number and email
Name (forename/surname)  
Address
 
 
 
 
 
Postcode
 
Email
 
 
Telephone
 

If you would like to attach any electronic documents in support of this form please use the browse buttons below.

Each file must be one of the following doc, docx, xls, xlsx, txt, pdf and the size of each file must not exceed 3MB in size.
File 1
 
File 2
 
 
File 3
 
 
File 4
 
 
File 5
 

Please use this space to supply any further information


   

Thank you for taking the time to provide this information.

Your query will be answered in accordance with our Personal Information Charter
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