Submit your collection

Application form

Do you want to submit your claim? Fill in your information below, and we will process your order within 24 hours.

    • 1

      Basic info2 minutes

    • 2

      Debtor details30 seconds

    • 3

      Your details30 seconds

    • 4

      Preview5 seconds

    1/4

    Basic info2 minutes

    Basic info2 minutes

    E-mail address*
    Are you private or business:

    Details claim

    Are you already a customer of Collection Company?
    Do you have money owed by a private individual or a company / organization
    Then you can here log in to the Online Cockpit. If you are logged in, you can easily create new collection files. Forgot your password? Request your password. Login not possible? Call us on 010-310 8000.
    Do you have a claim within the Netherlands, within Europe (outside the Netherlands) or outside Europe?
    Do you have one claim or multiple claims?
    Direct debit type
    Euro (Euro countries)
    Outstanding amount * :

    For a quick handling of your case, it is important that you fill in the form as completely as possible.

    When did your tenancy agreement end?
    Upload your rental agreement here

    For a quick handling of your case, it is important that you fill in the form as completely as possible.

    Which rental months are currently still open and what is the amount per month? Upload your specification here or specify it in the text box below.
    Rent arrears specification
    Upload your rental agreement here

    For a quick handling of your case, it is important that you fill in the form as completely as possible.

    Upload your rental agreement here
    Upload the decision of the rent assessment committee here
    For which months do you still need to receive an amount back and which months does it concern? Upload your specification here or specify it below
    Specification of amount to be refunded

    For a quick handling of your case, it is important that you fill in the form as completely as possible.

    Have agreements been made about the repayment of the loan?
    YesNo
    Loan specification

    Which month or months has/have not been paid and what amount? Upload your specification here or specify it below.

    Upload your employment contract here
    Which month or months has/have not been paid and what amount? Upload your specification here or specify it below
    Upload your verdict here
    Have you previously handed over this judgment to a bailiff?
    YesNo
    Have payments already been received?
    YesNo
    Which category of lease & rental does your receivable fall into?
    DepositOverdue lease/rental installmentsInjury
    Describe your claim below. State, among other things: date of damage, agreements made, description of damage
    Upload the correspondence, outstanding invoices and the agreement
    Are you the client or contractor (contractor)?
    Ik ben de opdrachtgever / hoofdaannemerIk ben de opdrachtnemer / uitvoerder Het werk is niet opgeleverdDe opdrachtnemer heeft schade aangerichtU heeft de overeenkomst ontbonden My client does not pay the invoice or invoicesMy client does not pay for the additional work
    Upload the agreement
    Upload the outstanding invoice or invoices
    What is the reference of the order – the invoice number?
    What is the order date?
    Has there been canceled?
    YesNo
    When was the overpayment paid?
    Choose what applies to you:
    I have paid too much wagesI paid an invoice twiceOther, upload or describe below
    When was the overpayment paid?
    Upload your receipt(s) here
    Comments / explanation of claim
    Relevant documents (contract, assignment, correspondence, general terms and conditions). You can upload multiple files
    Each file you upload can have a maximum size of 2 MB.
    Do you want to upload more files?
    Are your files too large? Please send them manually by email via WeTransfer to info@collection-company.com.

    Debtor details30 seconds

    Enter the details of the person who owes you money below.

    Salutation
    Debtor's first name
    Debtor insert
    Surname Debtor
    Debtor company name*
    Legal form
    Chamber of Commerce number
    Salutation
    First name contact person
    Prefix contact person
    Last name contact person
    Postal Code
    House number
    Addition
    Street name
    Residence
    Country
    Debtor email address*
    Phone number
    Mobile

    Your details30 seconds

    Enter your information below.
    Company Name*
    Legal form
    Chamber of Commerce number
    Salutation
    First name contact person*
    Prefix contact person
    Last name contact person*
    Postal Code*
    House number*
    Addition
    Street name*
    Residence*
    Country*
    Phone number
    Mobile
    IBAN-number*

    Preview5 seconds

    Are your details correct

    You can check and adjust them by going back. Yes, initiate my claim and I agree to:



    Signature:

    Why 40.000 customers have gone before you

    • The #1 collection company in the Netherlands and abroad
    • Regional & local specialists
    • Years of experience with international invoices
    • Your own personal contact
    • Extensive advice on the legal process
    • Monitor the status of your case 24/7

    +3170 - 410 2800

    Willems, M.
    Willems, M.
    Didn't expect it to go fast. Unbelievable that you are busy for ages and then you finally hire someone else and then they can suddenly pay. It's good that these types of collection companies exist.

    Meet our specialized legal team