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Solicitors Online Referral Form

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Please fill all boxes that are marked 'Required'.

1) Your Details

Your Full Name (Required)

Name of Firm (Required)

Your Address (Required)

Post Code

Your Direct Telephone No

Your Fax No

e-mail

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2) Your Client's Details

Client's Name

Client's Address

Client's Post Code

Client's Daytime Telephone No

Client's Email Address (if known)

3) Details of Other Party

Other Party's Full Name

Other Party's Address

Other Party's Post Code

Other Party's Daytime Telephone No

Other Party's Email Address (if known)

4) Other party represented? Details:

Name Of Contact At Other Party's Solicitors

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Other Party's Solicitor's Direct Telephone No

Other Party's Solicitor's Fax No

Other Party's Solicitor's Email Address (if known)

5) Please indicate the following:

What Issues Are To Be Resolved:

Children
Finance
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If Other, Please Explain

Publicly funded mediation?

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Future Mailings (Required)

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Copy of referral required?

News: Co-Owners - A Timely Reminder Aug 06, 2010; New Claims Process for Personal Injury Cases Jun 02, 2010; Home Information Packs Scrapped May 20, 2010; Capital Gains Tax May 14, 2010; Freedom Of Choice - Choose A Solicitor That You Want May 05, 2010; More news…

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Pengillys is a trading name of Pengillys LLP which is a Limited Liability Partnership registered in England under number OC342605. It is regulated by the Solicitors Regulation Authority as Pengillys LLP under number 0005914 for our Weymouth office and number 00426842 for our Dorchester office. Its registered office and principal place of business is at Post Office Chambers, 67 St Thomas Street, Weymouth, Dorset, DT4 8HB.