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Client Verification Form
Complete and submit your details online
Step 1 of 3 - Your details
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Your Reference Number
Reference Number
*
e.g. A00006-0010
Your details
Your full name
*
Mr
Mrs
Miss
Ms
Prefix
First
Middle
Last
Marital status
*
Occupation
*
National Insurance Number
*
Maiden Name
*
Gender
*
Male
Female
Date of birth
*
Landline number (Home)
*
Please insert your home telephone number even if you do not use it for telephonic purposes as it helps us to verify your identity from electronic records held by our data processing agent.
Landline number (Work)
*
Mobile number
*
Fax number
Your email address
*
Enter Email
Confirm Email
Current address
Your current address
*
Address Line 1
Address Line 2
City
County
Post Code
Your Passport Number
UK Passport Example:
1234567891GRB700101F1201019 - 04
This is the long number on the photographic page of your passport located at the bottom of the page under your photograph.
Your Passport Number
*
Upload a copy of your Passport (optional)
Accepted file types: jpg, jpeg, png, pdf.
Upload a scan or photo of the biometric (page with your photograph) of your passport.
Your Drivers Licence Number
Drivers Licence Number
*
Upload a copy of your Drivers Licence (optional)
Accepted file types: jpg, jpeg, png, pdf.
Scan or take a photo (front only) of your Driver's Licence
GDPR & Privacy Policy
Please read the following information, and if you agree, please print and sign your name below to enable us to carry out our electronic search.
I understand that by providing the information contained within this form, I am consenting for Adcocks to conduct an online search using Lexis Nexis’ IDU in order for my identity to be verified. I further consent for the information contained within this form to be used for completing the client case management system held by Adcocks and building my profile for the specific purposes of the legal work to be carried out.
Privacy Policy
*
By completing this form you agree with the storage and handling of your data by Adcocks Ltd.
Marketing information
I'm happy to receive marketing information from Adcocks
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