Quotation Request

Please complete this form as accurately as you can so as to receive the best possible quotation from us. Our quotation will be on a "non-advised" basis unless you ask us for advice.
Fields marked with "*" are required fields.

Personal Details
Title :
First name* :
Surname* :
Address* :

Town* :
County :
Postal code* :
Telephone* :
Email* :

Age & Health Details
	*You	Spouse/Partner
Date of birth :
Age :
Sex :
Smoker :
Health issues :

Pension Funds* If you at any time contracted out of the state pension scheme (SERPS/S2P) then one or more of your pension plans will have received National Insurance Contribution rebates. This will show up as "Protected Rights" in your pension plan statement, and these funds must be used to provide a 50% spouses benefit if you are married or in civil partnership. Please therefore enter Protected Rights funds separately from your other funds.
	Fund Size

Type of Pension	Protected Rights	Non-protected Rights





Total Funds :
Maximum Tax Free Cash (TFC) :
I want this much TFC :
Funds available for annuity :

Annuity wanted
Spouse's benefit :
Guarantee period :
Escalation :
Target retirement date* :

General
How did you find us? :
Employer (if applicable) :
I would like advice on :

Data Protection Act By submitting this form you are consenting to your information being passed to Goddard Perry Consulting Limited. We will not pass this information to a third party without your consent.
I accept your terms of business as detailed in your document "About us" :	*
I am happy that you make occasional contact :


or

Goddard Perry Consulting Ltd, Registered in England 1635689 - VAT No. 452 2581 59 - FSA Reg No 125376
8th Floor, Corinthian House, 17 Lansdowne Road, Croyden, Surrey, CR0 2BX
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