Instruct Us

Please complete every section of this form with as much information as you can. Please attach relevant files and/or scanned copies of all correspondence and other written material you have sent or received.



Your Details:
Title
Please select a title.
Full Forenames Forenames are required.
Forenames are required.
Surname
Surname is required.
Address
Address is required.
Post code
Postcode is required.
Telephone
A telephone number is required.
Alternative telephone
An alternative telephone number is required.
Email
Email address is required.
If the claim is being made against a company/organisation, please give the name
Company/Organisation name is required.
Your position in this company/organisation
Position is required.
Have you received any of the following?
(please tick as approppriate)
Letter Before Action from a solicitor
   
Details of the person/organisation making a claim against you or your company/organisation:
If the claimant is an individual, please give:
Title
Please select a title.
Full Forenames A value is required.
Forenames are required.
Surname
Surname is required.
   
If the claimant is an organisation, please give:
Full name of the organisation
Company/Organisation name is required.
Address
Address is required.
Post code
Postcode is required.
Telephone
Telephone number is required.
Email
Email is required.
   
Details of the Claim:
Please state the amount of money being claimed from you
A claim value is required.
   
Particulars of the claim – please explain what this claim relates to and why you believe you should not pay this amount
Claim particulars are required.
   

Please select files and/or scanned copies of all the correspondence and other written material you have sent or received. This may include the original cost estimate/proposal, an invoice, letters demanding payment/solicitor’s letters.

Max file size allowed = 500KB

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Statement of truth:
I believe the facts stated in the form are true
You must make a selection.
Signed (initials and surname)
A signature is required.