Claim Forms. Please print, complete and return to (no stamp needed):

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1 Claim Forms Please print, complete and return to (no stamp needed): Claims Thru Us Freepost RRZK-YTRL-UEXT 1 Farnsworth Court West Parkside LONDON SE10 0QF Please enclose a copy of your loan/credit agreement if available. For credit cards, please enclose a copy of your statement. If you have any questions, please call us on: to sign, or we can t claims@claims-thru-us.co.uk

2 Letter of Authority First Client Name: Second Client Name: Client Address: Postcode: Home Phone: Work Phone: Mobile: Name of loan/credit card company: Loan/Credit Card Number(s): 1 I/we, the undersigned, authorise Claims Thru Us Ltd to act on my/our behalf as agents in pursuing my/our complaint(s) in respect of advice received and sales made by your firm in respect of the sale of a Payment/Loan Protection Policy. This authorisation includes your agents, representatives and associates of your firm and its predecessors. 2 I/we confirm that I/we have a lawful contract with Claims Thru Us Ltd and have expressly consented that all communication from you must be made direct to Claims Thru Us Ltd. 3 I/we hereby advise that wilful failure of the Insurance Provider / Financial Advisor / Loan Company to follow my/our express instructions with regard to dealing with Claims Thru Us Ltd who I/we have contracted with may render the offending party liable to legal recourse for procuring/inducing a breach of contract; restraint of trade; breaches of the Competition Act 1998, the Enterprise Act 2002 and Articles 81 & 82 of the EC Treaty. 4 Please take this letter as authority requiring you to deal directly with Claims Thru Us Ltd and to provide any information that Claims Thru Us Ltd requests as necessary to pursue my/our complaint(s) fully. This authority will endure until further notice. A copy of this letter of authority shall have the same validity as the original. 5 All future correspondence should be forwarded to Claims Thru Us Ltd. 6 I am/we are aware that if my/our complaint is successful, my/our policy(ies) will be cancelled and cover will cease. 7 I/We authorise the financial company to pay any Compensation due directly to s client account. I/ we authorise to deduct its fee from such Compensation and pay the balance to me/us. 8 I/we confirm that the information provided to Claims Thru Us Ltd is to the best of my/our knowledge correct. 9 I/we confirm acceptance of this agreement and give full authority to pursue the complaint. to Please sign, don t or we forget can t to process sign, or your we claim can t PLEASE TICK I/we have read the pre-contract information supplied and agree to be bound by the Terms & Conditions as provided in our claims pack and available on the company website: CTU/1/ First Client Signature: Date of Birth: Second Client Signature: Date of Birth: (if a joint policy) claims@claims-thru-us.co.uk

3 PLEASE TICK AS APPROPRIATE Do you believe you have been mis-sold a Payment Protection Policy (PPI): Yes No I don t know Please give us some details... Name of loan/credit card company Loan/card number Loan/PPI Start date (if known) Loan Amount (if known) Cost of PPI (if known) Is the loan ongoing? or paid off? What was the purpose of the loan? How did you apply for the loan? Face to face Postal Over the phone Internet Have you complained about mis-selling of your PPI before? About you at the time of lending Were you: Employed Self-employed Working less than 16 hours p/w Temping Not working Occupation Start Date Employment benefits: Sick pay Accident pay Redundancy pay Maximum period sickness, accident and redundancy pay was payable: Did you have any health problems? No Yes please give details Did you have any other means of making your repayments? Savings Help from family Other insurance About the Sale 1 I was not made aware of the cost of the premiums for this policy and that I would pay interest on them. 2 I was not aware that payment protection was optional. 3 I was told that I would have a better chance of getting the credit if I chose to take the PPI. 4 I was not made aware that I had taken out a PPI when I took out the credit. 5 I did not receive any notification or documentation on why the policy recommended was suitable for my needs. 6 I did not speak English fluently at the time I was sold the policy. to sign, or we can t CTU/2/ First Client Signature: Second Client Signature: (if a joint policy)

4 CTU/3/14/ What do I need to do? Please complete the claim application and read and sign the terms of business and letter of authority. Then send them back to us along with copies of any relevant documentation. 2. Do I need to provide any documents? If you have documents then it would be particularly helpful if you can send us copies, for example if you have a loan or credit agreement. If not, don t worry, because the letter of authority will enable us to get copies of the information from the adviser or insurance company. 3. What can I claim for? You can claim for the return of any PPI payments plus interest at 8% if your PPI policy was mis-sold. If you have been charged interest on your PPI payments, perhaps because it was included within a credit account, then you could claim the effect of the interest back as well. 4. How long will my claim take? The firms that sold the policy are required to resolve complaints generally with 8 weeks of receiving them. The average claim takes between 2 to 4 months to complete. We may also have to refer your claim to the Financial Ombudsman Service (FOS). We will be doing all we can to get your claim completed as soon as possible. 5. How much do I have to pay? You won t pay us anything unless we re successful in winning your claim, in which case you will need to pay us 14% plus VAT of the total redress offered. 6. How will my redress be paid? Redress can be paid in a variety of ways. Our fee is based on the total amount of redress that is applied, which includes cash payments and amounts offset against your loan or amounts used to restructure your loan. This is why it is important to tell us about any arrears you have in relation to the credit or loan accounts. The tables below set out some examples in more detail. Example 1 - Where all of the redress is paid as a cash benefit. Firstly, you may receive a cheque back for the amount of redress or it may be paid directly to your bank account. This is usually the way if your loan has been repaid in full or there s a refund due when you cancel the PPI policy. Total Redress 1,000 Our Fee (14% plus VAT) 168 Net amount of redress paid to you as cash 832 Example 2 - Where some of the redress is paid in cash and some is used to reduce your loan. If your loan or credit account is still in place with an outstanding balance then the lender may have to restructure your account. This means that the lender has to recalculate what your outstanding balance would have been if you had not been mis-sold the PPI policy. In this case, the remaining portion of the single premium PPI will have to be removed from the outstanding debt. Therefore, you will receive the monies you have paid towards the PPI in cash and then by removing the rest of the PPI charge the balance of your outstanding loan will be reduced. Total Redress 2,500 Of which amount offset against your loan balance 2000 Remaining amount paid as cash 500 Our Fee (14% plus VAT) which is based on the total redress of 2, Net amount of redress received by you as cash ( 500 less our fee of ) Pre-Contract Information If you have arrears on your credit account then the lender can use the redress to pay those arrears before making payment to you. If you have been issued with a default notice and your account has been terminated then the lender can use the redress to pay towards your outstanding balance as in the table below. Let s assume that the full amount of your loan ( 700) is outstanding. Your redress of 1,000 will first be used to pay the balance and the remaining 300 will be paid as a cash benefit. However, because our fee is 240 (based on the total redress) your cash benefit will be 60. Total Redress 1,500 Amount used to repay the outstanding loan balance 700 Remaining cash benefit 800 Our Fee (14% plus VAT) which is based on the total redress 252 Net amount of redress paid to you as cash ( 300 less our fee of 252) Can I claim if I am in a debt management plan, an IVA or have been made bankrupt? If you are on a debt management plan you will be able to claim but you should be aware that the compensation will be used to pay your creditors and you will still be liable to pay our fee. In this case we shall liaise with your debt management provider in order to arrange for payment of our fees. We do not accept cases that have been or are part of an IVA or bankruptcy. 8. Why should I use Claims Thru Us? You may make a complaint for the mis-selling of payment protection insurance directly to the advisor, broker or the bank who sold you the policy. You must do this in writing. If you are unhappy with the response, you may appeal to the Financial Ombudsman Service within 6 months of receiving the response. By appointing Claims Thru Us you will be using an experienced and well established claims firm that will be working hard for you to get you the compensation you may be entitled to. 9. What if I m not happy with the service you provide? We pride ourselves on the high level of customer service that we provide, but if you feel that we haven t delivered then we want to hear from you. We have a full complaints handling procedure and you will find a copy of this with the pack you have received. If you re not happy with our response to your complaint you can refer it to the Claims Management Unit at Claims Management Regulation, Monitoring and Compliance Unit, High Street, Burton on Trent, Staffordshire, DE14 1JSYou can telephone them on or them at consumer@claimsregulation.gov.uk 10. Can I change my mind? You can change your mind within 14 days of signing the agreement. You should tell us you ve changed your mind in one of the following ways: By ing us at: claims@canaryclaims.co.uk By writing (registered post):, 1 Farnsworth Court, West Parkside, London, SE10 0QF 11. What if I change my mind after the 14 day period? You can change your mind after the initial cancellation period by giving us 14 days written notice. If we ve already undertaken work on your behalf we may make a charge to cover our reasonable costs. is regulated by the Ministry of Justice in respect of regulated claims management activities. Our authorisation number is CRM2233 which can be checked on the website Example 3 - Where some or all of the redress is used to repay arrears on your credit account.

5 Terms & Conditions PART 4: These Terms of Business set out the agreement between you and. Please read the terms carefully to ensure that you are aware of them before signing the Letter of Authority. CTU/4/14/ Definitions Claim means the Client s claim or claim or claims against the company relating to the mis-selling of a Payment Protection Insurance policy or policies or the application of unlawful charges to the account(s) of the client. Client means the policy holder(s)/accountholder(s) whose details are set out in the Letter of Authority and who have appointed Claims Thru Us to provide the Services. Company means the financial institution and/or persons to whom the letter of authority is addressed being the Insurance Company, Bank, Building Society, Credit Card Company or Financial Adviser or any other entity which sold the policy or gave the advice to the Client, or applied the unlawful charges (including for the avoidance of doubt any employee, director, agents, representatives and associates of those entities or any other entity and/or any of their predecessors). Compensation means any sums paid or awarded in respect of any claim made by us on your behalf. This includes all nonmonetary benefits in whatever form including but not limited to all benefits that will arise from any waiver, cancellation, reduction, saving, deduction or rescheduling of any outstanding or future loan or interest payments or associated loans, compensation, gesture of goodwill, refunds, discounts, any reduction in the loan outstanding and/or any interest or capital recovered including all associated or refinanced loans. Where such an offer is revised on appeal, then the higher amount shall be used in order to calculate the amount of the compensation subject to client being still in contract. Fee means the fee of 14% plus VAT of the total compensation payable. Letter of Authority means the letter included in the claim pack to be sent to the Company from the Client. Services means the work which we will undertake on your behalf in respect of your Claim including assessing the viability of, preparing, submitting and negotiating your Claim and which is set out more specifically in clause 3. Terms means these terms and conditions. Us, We and Our means, a limited liability company registered in England and Wales with number having its registered office at 1 Farnsworth Court, West Parkside, London, SE10 0QF. You and Your means the client(s). 2. Duration: a) The contract shall commence on the date you sign and return these claim terms to us and, unless terminated earlier as per clause 6 below, will continue until the earlier of: I. Compensation is recovered for you by us and you have paid the Fee, or II. We have advised you in writing that in our opinion your claim is unlikely to succeed and we are declining to act for you. 3. We agree to: a) Review your claim application and assess the likelihood of your claim being successful. b) If after we have reviewed your application, it is our opinion that your claim is unlikely to be successful we may decline to act for you. We will notify you of this fact in writing. c) If we accept your claim application, we will confirm this to you in writing and prepare and submit your claim to the company that sold you the PPI policy or financial product. d) We will liaise with the company and use reasonable endeavors to pursue your claim. e) We will notify you promptly of any requests for additional information or documentation that the company need to investigate your claim. f) Notify you in writing of any offers of compensation made by the company. g) Obtain your agreement before accepting or rejecting any offer or h) Notify you of any circumstances beyond our control which prevent us from performing the services under this contract. 4. You agree to: a) Appoint us as your exclusive agent to handle this claim. This means that you cannot appoint another person or firm to act on your behalf in respect of this claim, unless you terminate this agreement with us. b) Provide full authority to us to deal with the company on your behalf. c) Provide truthful and accurate information regarding your claim. d) Provide copies of all documentation that are in your possession and which relate to the claim. e) Respond promptly to requests by us for further information, or documents that may be needed to progress your claim. f) Pay our fee due as a result of a successful claim. g) Upon receipt of an invoice for the fee, you will pay the amount due to us within 7 business days of you receiving the h) When an offer for Compensation is obtained from the company on your behalf which in the reasonable opinion of us is fair and reasonable having regard to the relevant circumstances and that offer is rejected by you, then we reserve the right to charge a fee equal to the amount of the fee which would have been payable in the event that you accepted that offer in line with our advice. 5. Fees a) Our fee is 14% plus VAT of the compensation which we obtain for you as a result of a successful claim. For example if we recover 1,000 compensation, the fee would be VAT = 168. Another example would be where the compensation is 2,500 which is applied as a reduction in the client s loan of 2,000 and a cash payment of 500, our fee would be VAT = 420. b) We will not charge you if the claim is unsuccessful. c) Where we receive compensation directly, we will issue you an invoice for the amount of our fee and deduct the fee directly from the d) If the company does not pay the compensation directly to us, we will send you an invoice for an amount equal to 14% plus VAT of the e) Our fee must be paid within 7 business days of you receiving the f) We reserve the right to charge you interest on all sums which have not been paid by you at the rate of 2% per annum over the base lending rate of Barclays Bank. g) We reserve the right to charge you for any reasonable costs incurred in seeking to recover our fee from you. 6. How You Can Cancel This Agreement a) You have 14 days from the date of signing this agreement to cancel your authority for us to act on your behalf. Cancellation is without charge and you will have nothing to pay under this agreement. b) You can cancel the agreement at any time after this by giving us 14 days notice. Cancellation must be done in writing and sent to the company via registered post or by . c) If you cancel the agreement in accordance with clause 6b above, we reserve the right to charge a fee to cover our reasonable costs for the work undertaken in processing your claim up to the date of cancellation. d) If at the time of cancellation described in 6b above, we have received an offer of compensation, which has been calculated in accordance with the rules of Financial Services Authority or the principles used by the Financial Ombudsman Service and which we recommend is accepted by you, we reserve the right to charge the full fee. 7. How We Can Cancel or Change This Agreement a) We can cancel this agreement by giving you 14 days notice in writing if any of the following events occur: I. We become aware that your claim is unlikely to succeed. II. You are declared bankrupt. III. You enter into an Individual Voluntary Arrangement with your creditors or have a Bankruptcy petition presented against you. IV. You do not follow any reasonable recommendations made by us. V. You provide information which you knew to be false or misleading in support of your claim and this information is material to the success of your claim. VI. You fail to respond to reasonable requests for information in a timely manner and this prevents us from providing the services. b) Subject to the notice period in clause 7c below, we may change the terms of this agreement from time to time to reflect the increased cost of providing the service to you, to reflect changes or predicted changes in legislation, taxation or regulation, or as a result of decisions made by the Financial Ombudsman Service. c) We will always give you at least 30 days written notice of any changes before they take place. If you are not willing to accept the proposed change, you will be free to end the agreement and you will have no further amount to pay under the Agreement. 8. General Conditions About This Agreement a) This Agreement is governed by English law. b) You cannot transfer your rights and obligations under this Agreement but you can terminate the Agreement in accordance with clause 6 above. 9. Regulation The is regulated by the Ministry of Justice in respect of Our authorisation number is CRM2233 which can be checked on the website

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