Reply Form

About You

Your Reference:

Your Name:

Your Postcode:

First Line of Your Address:

Your Email:

Your Phone Number:

About The Debt

Do you owe the debt?

What Do You Want To Do?

How will you pay?

When you submit this form you will be taken to the Payment Page.

When you submit this form you will be taken to the Financial Statement.

How much do you think you owe?

The amount you think you owe (£):

I don't owe any more than this because:

What do you want to do?

What do you want to do next?

Supporting documents can include things such as bank statements, proof of payment etc. Files must be in PDF, Word or JPG format (maximum 2MB each in size). Please note that large files may take a long time to upload, so please be patient and only click the 'Submit Form Now' button once.

Alternatively you can email the files directly to [email protected]. Please include your reference in the subject line.

Supporting Document 1:

Supporting Document 2:

When you submit this form you will be taken to the Financial Statement.

Your file will be put on hold for 30 days

You have accepted that part of the debt is due however you are not at the stage of making any offer. In view of this, please review financial statement.

I would like to seek debt or legal advice

Your file will be put on hold for 30 days

I also wish to fill in a financial statement:

When you submit this form you will be taken to the Financial Statement.

Please contact us

We would recommend you seek independent legal advice. Please be aware that organisations such as the Citizens Advice Bureau can provide this for free should you require it. If you would like to request further information, you can email [email protected].

Please let us know why you dispute the debt

I dispute the debt because:

You can submit supporting documents if you wish. Supporting documents can include things such as bank statements, proof of payment etc. Files must be in PDF, Word or JPG format (maximum 2MB each in size). Please note that large files may take a long time to upload, so please be patient and only click the 'Submit Form Now' button once.

Alternatively you can email the files directly to [email protected]. Please include your reference in the subject line.

Supporting Document 1:

Supporting Document 2:

You can request additional documents or information. Please give details below (optional).

I require the following additional information:

Do you require 30 days to seek advice?

When you submit this form you will be taken to the Financial Statement.

Confirmation

I confirm the information given is true.

Print Name:

Date:

DCB Legal Ltd is a limited company registered in England and Wales with number 10633864 and is authorised and regulated by the Solicitors Regulation Authority under SRA registration number 638321.

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