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Case Specific Claim Form

Complete the form below and click on the 'Submit Form' to submit your query.

Case Name
Our Organisation Details
Contact Name
Tile
Organisation
Address
Postcode
Telephone
Fax
Email
Details of Claim
Total amount of your claim, including any Value Added Tax as at the date of the liquidation
Details of any documents by reference to which the claim can be substantiated (eg invoices, delivery notes, correspondence)
Particulars of how and when the debt was incurred
Please advise if your claim cannot yet be calculated with certainty and, if so, when you expect it to be finalised.
Particulars of any security held, the value of the security and the date it was given. (Give details of how you have valued your security)
Please advise if you are claiming retention of title to goods that you know are still in the company's possession.

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This document explains the relevant position only in general terms. We do not intend it to be used as formal advice about a specific situation, for which you should consult with a qualified insolvency practitioner and not rely upon this document. Portland would be pleased to advise you formally and you should contact one of the directors listed to arrange this. Portland regrets it is unable to accept any responsibility to anybody who seeks to rely on this document.