Report additional loss in connection with repayment of previously collected debt

If you believe that you have suffered an indirect loss or other loss in addition to the amount that you will be repaid, please report this by filling in this form and returning it to us.

When we have received the request, we will go through it and contact you as soon as we possibly can.

If you have any questions about how to fill in the form, please do not hesitate to contact us. 

 

* Mandatory fields

Attach documentation:

Here you can attach files to document your loss. You can upload up to 10 files at a time. Each file cannot exceed 4MB. You can upload most digital photo file formats, as well as Word/docx/doc, Excel/xslx/xls, Pdf, Tekst/txt, Jpeg/jpg, Png or Gif files.

File Size Exceeds the Limit
Delete File Size Exceeds the Limit

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