| Request Funding Advice |
| Independent advice on issues relating to funding Long Term Care |
| Independent financial advice specialising in Care Planning, Investment and Inheritance Tax Planning |
| Moving home and selling my property |
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| Forename:* | |
| Surname:* | |
| House Number: | |
| Street:* | |
| Town: | |
| City: | |
| County: | |
| Post Code:* | |
| Daytime Phone:* | |
| Mobile: | |
| Email: | |
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| Is this query for: | Myself Friend/Relative |
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| This section only needs to be completed if you have selected to receive funding advice. |
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| Do you own a property? : | Yes No |
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| Is the house occupied by anyone other than the person requiring assistance ? | Yes No |
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| Please indicate the combined value of your current assets and capital: | |
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| How soon will care be required | |
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Property Type: | Detached house Semi-detached house Bungalow Flat
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| Approximate property value: | |
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| Comment | |
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