PMR Request Form

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1. PARTNER SUBMITTING PMR REQUEST. *

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2. TYPE OF PROSPECT CLIENT. *

Organisation
Individual

3. COMPANY REGISTRATION NUMBER IF APPLICABLE.

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4. NAME OF PROSPECT CLIENT. *

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5. ADDRESS. *

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6. POST CODE. *

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7. WEBSITE. *

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8. CONTACT NAME. *

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9. POSITION. *

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10. CONTACT TELEPHONE NUMBER. *

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11. CONTACT E-MAIL ADDRESS. *

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12. POTENTIAL TYPE OF WORK. *

Property Commercial
Property Residential
Employment
Litigation
Intellectual Property
Tax Planning & Share Schemes
Landlord & Tenant

Construction
Financial Advice & Services
Trusts & Probate
Insolvency & Restructuring
Debt Collection
Corporate Commercial

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13. POTENTIAL ANNUAL FEES. *

£0 - £20,000
£20,001 - £50,000
£50,001 - £100,000
£100,000 +

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14. CLIENT SOURCED VIA. *

Prospect Client
Previous Client
Recommendation/Referral by Existing Client

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15. CONFIDENCE OF CONVERTING TO A CLIENT. *

25%
50%
75%
100%

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16. ADD INFORMATION TO SUPPORT YOUR PMR REQUEST. *