Submit a request – Simply Be

To send us an email, please select your reason for contact below, fill in your details and click submit:

Your email address

Account Number (eg A1234567)(optional)

Full name (as registered on your account)

First Line of Address

Postcode

Telephone Number(optional)

Is your payment already overdue?

How long do you require support for?

Are you able to make your usual payments?(optional)

Please select which brand(s) you have an account(s) with (select all that apply)

What's the main reason for difficulty with your payment?

Loss of income - Please provide details

Please provide details of your illness

Life event - Please provide details

Are you receiving support from friends/family/your GP?

Are there other reasons affecting your ability to make a payment?

Select what other reasons cause difficulty with your payments? - Please select all that apply

How long will this affect you for?

Does this reason affect your ability to manage your account or communicate with us?

Please describe how this affects you

Would you like to provide authorisation for a third party to be able to discuss your account with us?(optional)

Who would you like to authorise? Please provide their full name and their relationship to you

Are you up to date with your priority bills? For example rent, electricity or gas.

Are you up to date with any priority bills? For example rent, electricity or gas.

Do you have a plan in place, that is up to date, with payments being made?

Are you in receipt of full time income/benefits?

Are you able to maintain a payment every 28 days?

How will you be able to maintain a payment?

How much can you afford to pay every 28 days? If you have multiple accounts, how much can you pay on each account every 28 days

By ticking this box below, you confirm that you can maintain your priority bills with this payment.

If we can offer a reduced payment, how long would you need this for?

If we can offer a reduced payment, can you make the payment before the next due date?

What date can you make the payment of the reduced amount?

Is 28 days enough for you to arrange plans for your priority bills?

Please read below and tick the below box to confirm.(optional)

• When a variation to a credit agreement is put into place your credit facility will be temporarily removed from this and any other account you have with us, this means you won't be able to place any orders on credit with us whilst the arrangement is in place. Any agreed payment arrangement information will be reflected on your credit file and is regularly updated. This could affect your ability to obtain credit and any late payments will be recorded on your credit file. Payments are required every 28 days and must reach us by the due date on your statement. If you keep your minimum payments up to date any reminder letters, calls and late payment charges will stop. If the minimum payments are not received on time, this could result in the arrangement being cancelled. Payment arrangements are a temporary measure and will be reviewed on a regular basis, if we make any changes to an arrangement, we will send you notification in writing. Please be aware, that whilst your account remains on a payment arrangement, it may be sold/passed to a third party collection agency who will then administer the account. We will confirm this in writing to you separately, including details of your first payment date.

By ticking the box below, you consent to this information being recorded so we can support you and help you manage your account. The personal information we store will only be seen and used by us for these purposes.

If you’d prefer that this information is not recorded this can be removed. More information about how we process personal data and your rights can be found in our privacy policy which is available on our website (under ‘My Account> Privacy Policy) or a copy can be emailed or posted to you.

Please provide any information relating to your enquiry

(if you have no further information, please enter N/A)

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