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NWB PPI Offer Acceptance form
 
Progress IndicatorProgress indicator - You are currently in the Your Details section of the application form. This is section 1 of 2.
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 Confirmation

 

 

PPI Offer Acceptance form

This application form collects information to include within your NWB PPI Offer Acceptance form. Use the appropriate buttons at the end of the application form to proceed or to end your application.Please be aware that some explanatory text is included within the form.

This is stage 1 of 2. Required fields are indicated with an asterisk (*). Please do not use your browser's 'back' button to move back or you may lose some of the information you have already entered.



WHAT IS THIS QUESTIONNAIRE FOR?

This questionnaire is for customers to accept the Payment Protection Insurance (PPI) complaint offer.

WHAT DO I NEED TO DO?

Please fill in this questionnaire, giving as much information as you can.
If you need any assistance in completing this form, please call us on 0800 015 0319.
Are you completing this form on behalf of ? *  
 

Your name and contact details


Please note: for joint policies, a separate form should be completed for each named party.

PPI Offer Amount



Please enter the net offer amount. This can be found in the our offer section in our letter.

Your Payment Bank Account Details



  • Please enter the details of the account you would like us to credit.

  • The account name must match the name on your PPI Complaint.

  • Payments can only be made to valid UK bank accounts.

  • If these fields are left blank, payment will be made via an alternative method.
Do you want an electronic payment? *       
Account Type  
 
Please note that every effort will be made to credit the account you have specified however where this is not possible, payment will be made via an alternative method.