First Name

Last Name

Date of Birth

Street Address

Address Line 2

City

Post Code

Email Address

Phone Number

Name of Lender1

LS Claims Ltd T/A Ingram Toft, authorised and regulated by the Financial Conduct Authority (FCA) for regulated claims management services. Our firm reference number is: 831386. You can check this on Financial Services Register at https://register.fca.org.uk. For more information, please visit our website: www.ingramtoft.co.uk

If Other, Please Specify (Required)

Date loan started

Date loan ended

Loan agreement number

Total loan amount

Loan duration

Monthly payment

Number of loans

Do you have loans with other lenders?

Yes

No

Name of Lender2

If Other, Please Specify (Required)

Date loan started

Date loan ended

Loan agreement number

Total loan amount

Loan duration

Monthly payment

Number of loans

Do you have loans with other lenders?

Yes

No

Name of Lender3

If Other, Please Specify (Required)

Date loan started

Date loan ended

Loan agreement number

Total loan amount

Loan duration

Monthly payment

Number of loans

Employment status at time of the lending?

How would you describe your credit rating at the time of the lending?

Good

Poor

Did your lender contact you about your income status before granting the loan?

Yes

No

What are the documents they required you to submit when you applied for the loan? Choose all that apply.

Bank Statement	Credit report
Income and Expenditure Form (Income declaration)	None

Do you have Loans with other lenders while paying your high-cost lending loan? Choose all that apply

If other, please specify

What's your reason for taking out the loan?

Were you paying more than 25% of your income for your debt repayments at the time of the lending?

Yes

No

Thank you! You are almost there. Just a few more steps before we can begin to process your refund claim.

Please indicate here all the names that you have used previously during the time of your lending.

Please indicate here all addresses that you have used at the time of the lending.

Please give a brief explanation as to your financial circumstances when you took out the loans and any further information you wish to give.

What was your average monthly income at the time of the lending?

What was your average monthly expenditure at the time of the lending?

What is your average net monthly disposable income after expenses at the time of lending?

£0.00

Form of Authority Declaration

As provided for under DISP2.7.2 R of the FCA Handbook, which states that "A complaint may be brought on behalf of an eligible complainant, or a deceased person who would have been an eligible complainant, by a person authorised by the eligible complainant or authorised by law".

I/We hereby appoint and authorise Ingram Toft to act on my/our behalf in respect of my complaint and/ or claims for compensation in respect of my mis-sold/irresponsible/unaffordable lending claim and act on my / our behalf to seek compensation claim, request a Credit file from credit reporting agencies such as Experian and Equifax, and/or GDPR Data Request on my behalf under the Data Protection Act 2018.

I/We confirm that I/we have lawfully contracted with Ingram Toft and authorise you to comply with any request for information that may be made, whether by telephone or in writing (including fax or e-mail).

I hereby appoint and authorise Ingram Toft to act on my behalf to seek compensation in respect of all my loans and agreements. I confirm that Ingram Toft has full delegated authority to act on my behalf and settle my claim without further reverting to myself.

This instruction relates to all products or claims with relation to the above account/policy number.

Ingram Toft is a trading name of LS claims Ltd which is Regulated by the Financial Conduct Authority in respect of Regulated Claims Management activities (FCA no: 831386). ICO No: ZA096389 Registered Office: 13th Floor Piccadilly Plaza, Manchester M1 4BT. Vat No: 287011704

Sign Here and Date below

clear

Date Signed +

Its 100% No Win No Fee!!! If we do not get you a refund you do not pay us a penny!

First Name

Last Name

Street Address

Zip Code

Date of Birth +

Lastly, your lender may require a copy of one of the following current and valid identity documents from the list below:

Passport
UK biometric residence permit
Current driving license photocard (full or provisional, issued in the UK, Isle of Man, Chanel Islands or an EEA state)
HM Forces ID card
UK Firearms license
Any government-issued ID

Take a clear picture of your ID and upload it here:

Source

Payday Loan	Door Step Lending
Guarantor Loan	Rent to Buy Own loans
Other