Application for Certificate to act as an enforcement agent

Published date21 March 2018
Subject MatterEnforcement forms
Page 1
Application for Certicate to act as an enforcement agent
Please complete this form in BLOCK CAPITALS and send it to the
County Court Business Centre, 4th Floor, St. Katharine’s House, 21–27 St. Katharine’s Street, Northampton NN1 2LH
Are you applying for ( as appropriate)
A rst certicate to act as an enforcement agent
A renewal of a certicate to act as an enforcement agent
If you are applying to renew your certicate please provide the name of the court where your
certicate was granted and the expiry date.
Name of court Expiry date
EAC1 Application for a Certicate to act as an enforcement agent (07.17) © Crown copyright 2017
Part 1
1. Full name Date of birth
2a. Home address Phone No.
2b. Principal place of business Phone No.
2c. Which address is to be used for the purposes of this application? Business Home
3a. Have you ever applied for and been refused or had cancelled
a certicate to levy distress or act as an enforcement agent?
Yes No
3b. If Yes, please answer the following questions
Court to which the application was made
Date the application was refused
Court at which the certicate was cancelled
Date of the cancellation
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