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Collect Bad Debt Enquiry

Use this form to submit information about a bad debt to Ormita.

Your Details

First Name:

Company Name:

Last Name:

Your Contact Information

Personal Email:	Other Email:
Website Address:
Skype:	MSN:	QQ:
Phone:	Mobile:	Fax:

Address:

Postal Address:

Country:

Region:

City:

Debtor Contact Information

First Name:

Company Name:

Last Name:

Personal Email:	Other Email:
Website Address:
Skype:	MSN:	QQ:
Phone:	Mobile:	Fax:

Address:

Postal Address:

Country:

Region:

City:

Description of debtors products or services (what does the debtor company sell ?)

Debt Details

How old is the debt:

1 Month

1-3 Months

4 – 6 Months

6 – 12 Months

What was the debt for:

Steps already taken to recover the debt:

Phone Call

Debt Collection Company

Lawyer Letter

Court

Other

Explain why you think the debtor is unable to / unwilling to pay:

Barter Details

What type of goods / services are you interested in on barter in return for the debt:

Advertising	Graphic Design	Marketing / PR Services	Hotels / Resort Accommodation
Website Design	Website Hosting	Negotiable

Please provide a description of other goods / services you are interested in acquiring on a barter basis:

Are you an existing member of Ormita?

Yes

Important Information

Before attempting any recovery or contact with the debtor we will review this application and, if suitable, proceed with collection. In order to collect we will send you a signed agreement which you must return to us.

Please note: we will only credit your account when we recover goods or services from the debtor – not before. There is no cash fee to use our service and you acknowledge you will be paid in barter dollars – not cash – for the debt. These barter dollars are for use only within the Ormita network.

Ormita is the worlds single largest global barter network with operations across all continents.