Client Authority, Consent and Service Agreement
Use this form before Clearfile communicates with third parties or starts debt correspondence administration.
This form is a practical template and should be reviewed before public use. It does not create legal, financial, debt-advice or regulated professional services.
1. Client details
Full name: _______________________________________________
Address: _________________________________________________
Email: ___________________________________________________
Telephone: ______________________________________________
2. Matters / active debts covered
List each creditor, collector, organisation, account/reference number or matter covered by this authority.
| Organisation / creditor | Reference / account | Active / paused | Notes |
|---|---|---|---|
3. Authority to communicate
I authorise Clearfile Correspondence to receive, send and manage written administrative correspondence on my behalf in relation to the matters listed above. I authorise relevant organisations to communicate with Clearfile Correspondence for those matters.
Client initials: ________
4. Scope of service
Clearfile may provide administrative correspondence support, document organisation, account/reference tracking, timeline preparation, evidence collation, deadline reminders and administrative response preparation as agreed in writing.
Client initials: ________
5. Excluded services
I understand that Clearfile Correspondence does not provide legal advice, financial advice, debt counselling, debt adjusting, debt-management plans, insolvency advice, claims-management services or regulated professional advice. Clearfile does not handle client funds.
Client initials: ________
6. No guarantee of outcome
I understand that Clearfile cannot guarantee that any creditor, lender, debt collector, solicitor, enforcement agent, ombudsman, regulator, court or third party will agree to pause, reduce, write off, refund, settle, close or otherwise resolve any debt, complaint, account or matter.
Client initials: ________
7. Client responsibility
I remain responsible for the underlying debt, account, agreement, payment decisions, settlement decisions, complaint decisions, court documents, deadlines and legal/financial consequences arising from my matter.
Client initials: ________
8. Fees
I understand that debt correspondence administration may be charged per active debt/account, plus any agreed setup fee, subscription fee, software fee or bespoke work fee.
Client initials: ________
9. Data handling consent
I consent to Clearfile processing relevant personal information and documents for the purpose of providing the agreed administrative service. I understand that information may be shared with relevant third parties where necessary for the authorised matter.
Client initials: ________
10. Signature
Client signature: __________________________________________
Date: _____________________________________________________
Clearfile contact: Charles Roberts, Clearfile Correspondence