The information you provide below will be loaded into the SAFE Parliamentary Action Group Computer database it will enable us to produce more accurate statistics for the All Party Parliamentary Group on Financial Exploitation, MP’s, Treasury, The Various Governing Bodies and Media we are registered with the Information Commission and all details are treated as confidential.

Title:

Mr. Mrs. Ms Dr.

Address Line 1:

Address Line2:

City:

County/State:

Postcode/ZIP:

Fax:

Mobile:

Which SAMS do you have?

Barclays:

bank_of_Scotland:

1
2
3
4
5
6

Monthly Repayment if applicable:

Property Value when SAMS was entered into:

Were conditions imposed and what did they cost:

Approx amount used in home improvements on property:

Are you able to stay in your home:

yes no

What % age of appreciation will the Bank Claim:

What were your age /ages 97/98 when product was sold:

Have you redeemed your SAM :

yes no

If yes when:

what figure did the Bank Take :

Do you need to sell

yes no

Did you have Legal Insurance Cover at the Time :

yes no

With who:

Have you approached them :

yes no

Outcome of this :

Have you contacted your Member of Parliament :

Yes No

Who is your MP:

We will use your details as statistics for our reports to the: All Party Parliamentary Group / Treasury / Governing Bodies etc. 

Are you prepared to go Public

Yes No

Are you willing to be added to possible future action :

yes no

All donations are gratefully accepted, as we are not for profit organisation

Secretariat to the All Party Parliamentary Group Against Financial Exploitation

SAFE is a Company Limited by Guarantee Registered in England and Wales. No.4853224

Registered office 69 Sutton Road, Heston, Hounslow, London TW5 0PN

Tel: 0208 630 9990   FAX: 0208 630 9900   E-mails: elainewilliams_safe@blueyonder.co.uk 

Website: www.safe-online.org

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Elaine Williams
Director SAFE
69 Sutton Road
Heston, Hounslow,
London TW5 OPN

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