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Contact

Please confirm that the customer is definitely over the age of 60 (both over 60 if a couple)

First Name

Last Name

Customer Telephone Number

Alternative Telephone Number

Customer Email Address

Best day to call the customer?

Branch Name

Your Name (Agent)

Your Email Address (Agent/Branch)

Additional Comments i.e. how many people are moving, funds available, location etc

I confirm that the customer has given consent for this information to be shared with Homewise and that they are expecting a call from Homewise

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