📄 Request for User Credentials Form

Tunisian Collection & Recovery Company

Subject: Request for User Credentials to Access and Track Deposited Files

Company Details:

Company Name:
Tax ID / Commercial Registration No.:
Headquarters Address:

Applicant Details (Legal Representative):

Full Name:
Legal Capacity / Title:[e.g., Managing Director]
ID / Passport Number:
Email Address:
Phone Number:

Request Body:

I, the undersigned, in my capacity as the Legal Representative of [Company Name], hereby submit this request to obtain a username and account access to your online platform to monitor our debt collection files.

Account Holder Designation:

[ ] Option 1: For myself, in my capacity as the Legal Representative.

[ ] Option 2: For a designated representative (Name: ...................., Position: ...................., Phone: ....................).

Declaration and Undertaking:

As the Legal Representative, I hereby undertake full responsibility for the authorized use of these credentials, maintaining confidentiality, and notifying your administration immediately of any changes.

Date
..... / ..... / 2026
Legal Representative Signature & Company Stamp