Transcript Power of authority

Power of authority
Herewith I authorise (principal)
Name
First name
Date of birth
Street /
Housenumber
ZIP code
Place
Phonenumber
the following person (authorised person):
Name
First name
Date of birth
Street /
Housenumber
ZIP code
Place
Phonenumber
This authorisation holds for (please mark)
□ Each current collection file all financial affairs at Intrum Justitia AG to handle for me and receive
every information which is essential.
□
The collection file ____________ the financial affairs at Intrum Justitia AG to handle for me and
receive every information which is essential.
This authorisation is (please mark)
□ Limited in time until ____________________(date) or
□ Unlimited
_____________________________
Place, date
Intrum Justitia AG
Eschenstrasse 12
8603 Schwerzenbach
Telefon
0844 85 33 32
_____________________________
Signature of the principal
[email protected]
www.intrum.ch
CHE-116.287.581 MWST
Verband Schweizerischer Inkassotreuhandinstitute
Association Suisse des Sociétés Fiduciaires de
Recouvrement
Associazione degli Uffici Fiduciari d’Incasso
Svizzeri