27th July 2008

WG Conveyancing

Instruct Us

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First Person

Title:

Forenames:

Surname:

Address:

Post Code:

Email:

Please let us have a number that we can contact you on most of the time.

Phone (daytime):

Phone (evening):

Phone (mobile):

Second Person

Title:

Forenames:

Surname:

Only complete if different from above.

Address:

Post Code:

Email:

Phone (daytime):

Phone (evening):

Phone (mobile):

Selling Or Buying

Selling and buying:

Selling only:

Buying only:

Remortgage:

HIP only:

Property Being Sold

Address:

Post Code:

On the market:

Sale Agreed:

Price:

Freehold house:

OR Flat/apartment:

Property Being Purchased

Still looking:

OR Address:

Post Code:

Price:

Freehold house:

OR Flat/apartment:

Introducer Details

*Company Name:

*Branch:

*Negotiator's initials:

*Name of person to whom you are referring this case and/or any additional information you think we need to know:

Private Client

Please tick if you are a private client:

* Please tick to confirm you have read our terms and conditions. By ticking this box you are undertaking that you have complied with the Solicitors' Introduction and Referral Code 2007 and provided the client with all relevant information concerning the referral and the amount of the referral fee payable to you.

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