FreightDeadbeats

DEADBEAT REPORTING

This is where you report a potential DeadBeat. We must verify they are a true DeadBeat before we can post them to our website.

Please complete all the required fields and we will contact you within three working days asking for specific information so we can verify if it is a true DeadBeat. We will only post DeadBeats that we can verify with written communication from the debtor.

YOUR DETAILS:

DEBTOR DETAILS:

Company:*

Address:

City:*

State:

Zip/Postcode:

Country:*

Owner:

Owner's email:

Contact:*

Title:

Tel:

Fax:

Email:*

DEBTOR TYPE*

Forwarders

Shippers

Consignees

DETAILS OF DEBT OWED:

If debt is in multiple currencies, please ignore this section and attach Statements of Account.

Total Debt: *

Currency:

Please complete the following details in respect of your debt- Alternatively, leave blank and once you submit this page, you will be given the opportunity to attach additional details. Those details would include documentation, statement of accounts, and acknowledgement of debt by the debtor/DeadBeat as well as any communications and other such proof of debt being owed. Please include the steps you have taken to collect the debt.

Has the company you are reporting filed for bankruptcy?
Jurisdiction	Bankruptcy number:
Have you reported or filed a complaint about this company to any government agency
Name of agency:	Location:
Phone Number:	Agency file number:

Date (MM/YY)	Amount Due *	Currency:*

More entries...

Date (MM/YY)	Amount Due:	Currency

Click the BROWSE button to the right and upload invoices and documentation regarding the debt. EMAIL TRAFFIC WHEREIN THE DEBTOR ADMITS THE DEBT IS IDEAL!! (Note - Document names cannot contain the characters #, &)

If multiple attachments, please zip or email to info@FreightDeadbeats.com

I certify the information I provided here within is true and correct and reflects the records of my company.