If you are a human and are seeing this field, please leave it blank. Page 1 of 5 Instruction Form Contact Name Your reference (if required) Company Name (if appropriate) Preferred Email Address Address Office Number Home Number Mobile Number Claimant Details Claimant Name Preferred Email Address Address Court claim number Office Number Home Number Mobile Number Page 2 of 5 Defendant Details Defendant Name Primary enforcement address Registered address for companies Trading Address Co Reg No (If known) Email Address Office Number Home Number Mobile Number Additional Defendant Information Was your judgment obtained by default? NoYes Date when debt was incurred (approx - if known) Please supply a brief summary of what the debt relates to? If the defendant is a person please provide description. Or better still a photograph if available and/or any relevant paperwork that will help the claim Successful enforcement relies upon accurate and detailed information about the defendant. Please complete all pages with as much information about the debtor as possible. Page 3 of 5 About the defendant Defendants date of birth (if known) Do you have the details of any vehicles the defendant uses? NoYes Please give details Do you have details of any other assets owned by the defendant? NoYes Please give details Are you aware of any recent changes in the defendant's circumstances? NoYes Please give details Are there any details of the defendants on the internet? NoYes Please give details Notes Please give details below of any information that may be useful to our Enforcement Agents or Team. (Continue on a separate sheet if needed) E.g does the defendant attend a gym? Where does he drink? Page 4 of 5 Fields marked with an * are required Authorisation I hereby authorise The High Court Enforcement Officers Office, or their transfer-up department, to obtain a writ of control in the name of an authorised High Court Enforcement Officer for the purposes of enforcement. * I confirm that the debt is not regulated by the Consumer Credit Act 1974 (unless over £25,000 and agreed before 1st April 2008) * I confirm that the details given are correct and accept any responsibility for any incorrect information given * For each case a £66 court fee is required. I will forward a cheque made payable to HMCTS to Penham Excel High Court Enforcement Officers, Ashley House, Siemens Road, Stafford. ST17 4DT I wish to pay by Debit or Credit card and request a member of the team to call me to make this payment. Copy of Judgment or Order (Copy of claim form if obtained online), Award or Settlement if not previously uploaded or provided. I confirm that the details given are correct and accept any responsibility for any incorrect information given * Signature By entering your details in the Authorisation Section you confirm that this constitutes an Electronic Signature. Signed * Date * Page 5 of 5 Fields marked with an * are required Thank you for choosing Penham Excel High Court Enforcement Officers to act on your behalf to collect the sums owed to you. What happens now? When we have received your completed application you will get a confirmation email from us. A member of our team will then contact you during office hours to discuss the case with you. At this time our team will be in a position to take electronic payment of the court fees. Once we have received the above details you can leave the rest to us. We will complete all of the relevant paperwork to obtain a writ of control in the High Court and commence Enforcement Action at the earliest opportunity. We will, of course, keep you informed of developments on the case(s) A copy of this form will be sent to the email address entered below. Email Address Confirm you have read our terms and conditions. * Read our Terms & Conditions here
