test-final - Rebate Gateway

Reference Number

YesNo

First Name

Last Name

Address Line 2

City*

Postcode*

Telephone Number*

Email Address*

Postcode*

Address Verification
Address history is essential for us to verify your identity.
Please let us know any other addresses that you have resided at within the last 10 years.

Have you lived at your current address for more than 10 years?

YesNo

Address* Line 1

Address* Line 2

City*

Postcode*

Does your current address and previous address cover the last 10 years of history? *

YesNo

Are you currently, or have you previously been a Housing Association of Local Authority (Council) tenant? *
YesNo

Step 3
About Your PPI Refund
Do you know which Banks/Lenders paid compensation to you directly or were the claims handled by an Insolvency Practitioner? *

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