If you would like to authorise us to distrain please submit the form below after filling in all the required fields marked with a *.
To:- Bristow & Sutor of Bartleet Road, Washford, Redditch, Worcestershire, B98 0FL or whosoever they may authorise holding a Bailiff's Certificate.
We (or I) do hereby authorise you to seize and distrain the goods, chattels and effects, in and upon the Office, Warehouse, House, Land and Premises, in the tenure and occupation of:
Tenant Name: *
Tenant Address: *
Post Code:
for the sum of: *
(the full amount you want us to collect)
being the rent due on: *
(insert date on which the latest sum of rent was due)
/
/ 20
calculated at: *
per
Week
Month
Quarter
and to proceed for the recovery of the said rent as the law directs and we/I do hereby indemnify you against any proceeding or proceedings that may be instituted against you, as well as against all fees or charges which you may incur or be liable to pay by executing this warrant, and do hereby undertake not to hold you accountable for any goods forcibly or clandestinely removed.
I acknowledge that I am bound by your Terms & Conditions that have been supplied to me or are available for inspection.
Date of Instruction: *
/
/ 20
Payment Timeframe: *
Levy & Collect Full Bal/Remove
Levy & 5 Days
Levy & Other
Special Instructions:
Name of Landlord / Agent: *
Landlord / Agent Address: *
Landlord / Agent Post Code:
Contact Email: *
Contact Tel: *
Name of Landlord if Different to Above:
Landlord's Address if Different to Above:
Post Code:
We can only distrain for rent due on commercial properties. Please tick to confirm this is a commercial property.
Is there a Lease or Agreement? *
Please select an option...
Yes
No
If discussed with B&S, person spoken to:
