Hirt-Urfer Ltd. is authorised to collect the following debt:
Debtor:
Title *
Mr.
Mrs.
First name *
Family name *
Street *
Postal code *
City *
Date of the bill *
Outstanding debts CHF) *
Subject
Client:
Title *
Mr.
Mrs.
First name *
Family name *
Street *
Postal code *
City *
Telephone *
e-mail *
Bank account (new customer, mutations):
Account number *
Bank (possibly SWIFT number) *
Postal code/City *
Remarks
We need an amount of green "Avis"
Please fill in all fields marked with *
