Please attach copies of invoices/statements and other correspondence previously issued to
your debtor relating to this debt.
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Note: Our fees will not be added unless proof of the above contract/agreement is sent with this form.
In submitting this Collection Request Form, I/we agree to pay CVM the Fee payable in accordance with the Debt Collection Services Term and Conditions irrespective of whether or not the Fee is recoverable from the Debtor or whether or not the Debtor pays the Fee.