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ACI Customer Reference * ACI Customer Name * Contact Number * Email * Payment Method * Offer Type * I confirm that all my priority bills such as; mortgage or rent, Council Tax, gas, electricity and water are up to date, or if not, they are in a repayment plan and that my offer of payment on this form is both affordable and sustainable. *

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ACI is a trading name of ACI-UK Limited. Company registration number 03775287. Incorporated in England and Wales. Registered Offices: 10 Whitehills Business Park, Whitehills Drive, Blackpool, Lancashire FY4 5LW.
Authorised and regulated by the Financial Conduct Authority for Consumer credit regulated activity, Firm Reference No. 708400. Registered with the Information Commissioners Office, Registration No: ZA116228. Credit Services Association Membership No. 987 (CSA Code of Practice).

ACI Customer Reference
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Email
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Offer Type
One-Off Settlement Amount
Payable By
Source of Funds
Regular Repayment Offer Amount
Regular Repayment Offer Frequency
Recurring Payment Frequency
Recurring Payment Amount
Priority Bills up to date

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