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Report a claim farmer

Report a claim farmer

Please answer all questions with a *. 

Are you providing this information for yourself or someone else?  
How did they contact you?
What was their contact number? Please enter all number/s that they contacted you on.
How many times were you contacted?  
Did the person or company attempt to refer you to a lawyer or law practice to make a claim?  
Did the person or company refer you to someone else to assist you in making a claim?  

Your contact details