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Your Full Name:
Your daytime telephone:
Your Email:
How did you find out about us:
Best Time to Call You:  

Name(s) and address of Creditor(s) :Creditor(s):
Name(s) of Debtor(s) :Debtor(s):

What is the debtor's current address?Debtor's Current Address:

Amount of Debt:Amount of Debt:
Date Debt Was Due:Debt Due Date:Has the debtor(s) made any payments towards the debt, if so how much?Payments:
Briefly describe the nature of the debt and the surrounding circumstances:Circumstances:
What reasons or excuses, if any, has the debtor given for failure to pay the debt:Debtor's Excuses:
What steps, if any, have already been taken to recover the debt (i.e. invoices, demand letters, statement of claim)?Steps already taken:

What information do you have about the debtor's assets and income? Please specify any property you suspect the debtor owns (i.e. real estate, shares, bank accounts).  Please specify any income that the debtor(s) may be entitled to (i.e. employment income, dividends, business income):Debtor Assets and Income:

This form is a request to a free consultation with a Toronto Debt Collection lawyer and the use of this form does not create a lawyer-client relationship between you and this law firm or any lawyers of this law firm. We look forward to discussing your legal issue.