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NewLaw Solicitors F: 0845 521 0946

Helmont House W: new-law.co.uk


Churchill Way
Cardiff
CF10 2HE
DX: 200759 Cardiff Bay

Claim Protection Form


Please complete and return this form along with your other papers straight away

Name: Mr Pasca
Address: 2 Swift Close
London
E17 5SU

Date of Birth: 23/10/1997


Telephone Numbers: Home: Mobile: 07534491352
Case Reference: 641529.001

Authority to deal with your claim:-

We owe you a duty of confidentiality as our client and can therefore only discuss your case with you. This
means that if you ask anyone else to call us on your behalf i.e. your partner or a parent we will not be able to
discuss anything with them. You may well be happy with this but if you would like us to discuss your case with
anyone else then please would you complete their details below:

Name:
Address:
Contact Number:

Please note that if you later decide that you do not want us to discuss your case with the above person then
you will need to let us know.

Wills

If you die during your claim then we will need to take instructions from the person entitled to deal with your
estate. If you do not have a Will in place then the law dictates who this will be and it may be someone that you
would not choose. In addition there could be serious delays in processing your claim.

Do you have a Will?

Yes □ If you do have a Will in place we would ask you to send us a copy for our file or let us know
where this is stored. If you send us a copy of the Will we will ask Ageas Law to carry out a free
review.
No □ If you do not have a Will in place please confirm who you would want to appoint to deal your
estate and your claim:

Name:
Address:

NewLaw Solicitors is the trading name of NewLaw Legal Limited, a limited company
registered in England and Wales with a registered number 07200038. NewLaw Legal
Limited is authorised and regulated by the Solicitors’ Regulation Authority. The
registered office of NewLaw legal Limited is at Helmont House, Churchill Way, Cardiff,
CF10 2HE. A list of directors is displayed at the above address. A copy of our privacy
notice is available on request via the above address or by email to
informationsecurity@new-law.co.uk.

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