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Consent Form
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Consent Form
Client Information
Title
Mr
Mrs
Miss
Ms
Mx
Sir
Dr
Lady
Lord
Other
Name
*
Date of Birth
*
DD slash MM slash YYYY
Address
*
Phone
*
Main Email Address
*
Unique Tax Reference (UTR)
National Insurance Number
*
Marital Status
*
Please Choose
Single
Married
Divorced
Widowed
Civil Partnership
Date of Marriage
*
DD slash MM slash YYYY
Date of Divorce
*
DD slash MM slash YYYY
Have you changed your Name?
*
Yes
No
Previous Name
*
Have you lived at your current address for less than 3 years?
*
Yes
No
Date current address effective from:
*
DD slash MM slash YYYY
Previous Address
*
Date previous address effective from:
*
DD slash MM slash YYYY
Do you have any finance related criminal convictions?
*
Yes
No
Please provide details of all criminal convictions, i.e. nature of conviction, date of conviction, etc.
*
Client ID & Consent to Perform an Electronic ID Check
Identification Documents
*
Drop files here or
Select files
Accepted file types: jpeg, jpg, png, pdf, Max. file size: 20 MB.
Please provide
one
form of identification from Section A &
one
from Section B
Identification documents accepted;
Section A - Government-issued documents with a photograph include:
- Valid passport
- Valid photocard driving licence (full or provisional)
- National Identity card (non-UK nationals)
- Firearms certificate or shotgun licence
- Identity card issued by the Electoral Office for Northern Ireland
Section B - Utility documents dated within the last 3 months:
- Bank Statements
- Credit Card Statements
- Utility Bills (Excluding Mobile Phone Bills)
- Council tax bills
Consent
*
Consent to performing a soft credit check:
By completing this consent form, you are providing your consent for Holmes & Co Accountants Ltd to complete an Electronic ID Check using the services of GB Group Plc and other credit reference agencies.
*
Consent For Use of Electronic Signatures and Documents
Consent
*
Consent to Electronic Signatures and Documents:
By completing this consent form, you are providing electronic consent to the use of electronic documents and signatures. Specifically, you are acknowledging and consenting to the use of electronic documents, e-mail delivery of documents, and electronic signatures.
*
Declaration
Consent
*
I hereby confirm my acknowledgment and acceptance of the Standard Terms of Business available at www.hcaccountants.co.uk/standard-terms-of-business.
*
Consent
*
I hereby confirm that the information provided in this form is accurate to the best of my knowledge and belief. Additionally, I consent to the collection and storage of my data by Holmes & Co Accountants Ltd, in accordance with their established data privacy policies.
*
Name
*
Full Name
Signature
*
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