Conveyancing Forms - Client Information Form

Conveyancing Forms - Client Information Form
Verification of Identity
In accordance with Government Regulations to prevent circulation of money arising from the proceeds of crime, we are required to record evidence of our client’s identity and require completion of this form.
Name
PrefixFirst NameMiddle NameLast Name
Your Official Correspondence Address*
Street Address
Street Address Line 2
CityCounty
Post Code
Date of Birth*
DayMonthYear
Date
Email
example@example.com
Home Phone Number
Area CodePhone Number
Mobile Phone Number
Area CodePhone Number
Work Phone Number
Area CodePhone Number
What is your employment status?
What is your Occupation?
Who is your Employer?
What is your National Insurance Number?*

Proceeds of Sale
Please indicate How and Where you would like the proceeds of sale to be sent. Please note, however, that there are some restrictions as to where funds can be sent. The default position is that the net proceeds of sale must be issued to the registered owners of the property.
Please indicate how you would like the net proceeds of sale to be sent at the end of the transaction:
Cheque payable to meBank Transfer to meCheque payable to another partyBank Transfer to another party
Please confirm the name on your bank account, sort code and account number (if your account is with a building society a reference number may also be required - please check with your bank)
Please confirm the name on your bank account to be placed on the cheque
You have indicated that you would like the net proceeds of sale to be sent to another party. Please confirm the name on their bank account to be placed on the cheque
You have indicated that you would like the net proceeds of sale to be sent to another party. Please confirm the name on their bank account, sort code and account number together with an explanation (if your account is with a building society a reference number may also be required - please check with the bank)

Existing Mortgage Information
If your property is currently subject to a charge on the title, please provide as much information as possible so that we can contact the charge holder and make arrangements for the removal of their security on completion of your transaction..
Address of the Property being sold
Street Address
Street Address Line 2
CityPost Code
County
How many mortgage lenders hold a charge over this property?
123
Name of Lender 1
Insert Mortgage Account Number Lender 1
Name of Lender 2
Insert Mortgage Account Number Lender 2
Name of Lender 3
Insert Mortgage Account Number Lender 3

Client Acceptance
I confirm that I have read the Client Care Documents sent in conjunction with this form and accept the terms and conditions set out therein and in the supporting documentation. By submitting this form I hereby give Medway Law consent to proceed with my transaction.
I hereby give you authority in respect of the following:-
1. Authority for Medway Law to contact our existing Lender(s) and obtain a redemption statement and any other information necessary to process the sale of our above property
2. Authority for all title deeds (and any other documents) held to be sent to Medway Law.
3. Authority for Medway Law to redeem our existing mortgage(s) secured against the property.
By signing this form you are confirming that all the information provided above is true and accurate*
Should be Empty:

Verification of Identity