Details
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Name of bankrupt / disqualified director / person complained of
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Name & address of company he / she is involved with (if applicable)
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Name (forename/surname)
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Address |
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Postcode |
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Is the above named company still trading?
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Are you are giving the following information on behalf of a partnership or company?
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If YES, please complete the following |
Business name
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Type of Business (e.g. company/partnership)
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Your position in the business (e.g. director/partner/manager)
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Business address (if different from above)
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Address |
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Postcode |
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Are you, the partnership or your company owed any money by the company in which the (bankrupt / disqualified) director is involved?
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If YES, how much?
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How long has the debt been outstanding?
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Were any references given when the account was opened?
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Were any representations made by the bankrupt / disqualified director in order to obtain credit, either by writing or verbally?
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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?
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What are your reasons for believing that the individual has taken part in the company's management or otherwise directed its affairs?
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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?
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Are you aware of any other persons who can support what you have to say? If yes please supply their details
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Name (forename/surname)
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Address
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Postcode |
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About you
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Please provide your full name and address, telephone number and email
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Name (forename/surname)
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Address
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Postcode
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Email
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Telephone
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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.
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File 1 |
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File 2 |
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File 3 |
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File 4 |
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File 5 |
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Please use this space to supply any further information
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