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Customer Request Form

How can we help you today?

Title *

First Name(s) *

Surname *

Date of Birth *

Telephone Number *

Email Address *

Certificate Number *

What type of policy do you have?*

Are you a landlord or letting agent?*

Landlord Letting Agent

Please enter your company name*

How do you pay for the policy?*

What would you like to do today?*

Do you have more than one policy that you wish to cancel?*

Yes No

Please upload your documents containing the relevant policy numbers and insured addresses for the policies you wish to cancel *

Do you wish to cancel from renewal?*

Yes No

Please specify what date you would like your policy cancelled from *

What is the reason you wish to cancel today?*

What method would you like to receive confirmation this request has been completed?*

E-mail Post

Address Line 1 *

Address Line 2

Town *

County *

Postcode *

Please confirm the following statements*

I have an insurable interest in the property
The property will only be used for residential purposes by the tenant(s)
The property will only be let to tenants aged 18 or over
An acceptable tenancy agreement will be in place for the duration of this policy
The required credit and ID checks have been carried out on the tenant(s) or guarantor
The first month's rent has been paid, or will be paid before allowing the tenant(s) into possession of the property
All statutory pre-grant notices have been issued, or will be issued before allowing the tenant into possession of the property

I Confirm

Do you want to make these changes to all the policies you have with us?*

Yes No

What method would you like to receive confirmation this request has been completed?*

E-mail Post

What is your new e-mail address? *

Do you want to make these changes to all the policies you have with us?*

Yes No

What method would you like to receive confirmation this request has been completed?*

E-mail Post

What is your new phone number? *

Do you want to make these changes to all the policies you have with us?*

Yes No

What method would you like to receive confirmation this request has been completed?*

E-mail Post

Do you require insurance documents for any other policies?*

Yes No

Please upload your documents containing the relevant policy numbers and insured addresses for which you wish to receive copies of your insurance documents *

How would you like to receive your insurance documents?*

E-mail Post

New Sort Code *

New Account Number *

Account Name *

Do you want to make these changes to all the policies you have with us?*

Yes No

What method would you like to receive confirmation this request has been completed?*

E-mail Post

What would you like to change the rent amount to? *

What method would you like to receive confirmation this request has been completed?*

E-mail Post

Address Line 1 *

Address Line 2

Town *

County *

Postcode *

Please confirm the following statements*

I have an insurable interest in the property
The property will only be used for residential purposes by the tenant(s)
The property will only be let to tenants aged 18 or over
An acceptable tenancy agreement will be in place for the duration of this policy
The required credit and ID checks have been carried out on the tenant(s) or guarantor
The first month's rent has been paid, or will be paid before allowing the tenant(s) into possession of the property
All statutory pre-grant notices have been issued, or will be issued before allowing the tenant into possession of the property

I Confirm

What method would you like to receive confirmation this request has been completed?*

E-mail Post

Please enter the characters shown below *

Write to us

Paymentshield Ltd,
Southport Business Park,
Wight Moss Way,
Southport,
PR8 4HQ

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Want to Chat?

You can call our customer services team on 0345 601 1050
Monday - Friday

8.15am - 5.45pm

Saturday

9am - 1pm
We also offer a live chat and bot service to answer any questions you may have
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Monday - Friday

8.30am - 5.30pm

Saturday

9am - 1pm

What our customers say

"Whatever I have needed has been sorted out there and then, within minutes"

Colin, Wisbech

"Knowledgeable, friendly and quick."

Catherine, Sothall

"Very polite, responsive and quick to help with any requests."

Fiona, Ayr

"I have always found staff very helpful, knowledgeable, and important for me, efficient."

Steve, Johnstone (Renfrewshire)

"Excellent customer service, felt valued."

Joe, Ashbourne

Call our Customer Service Team on 0345 601 1050

Monday - Friday 8.15am - 5.45pm

Saturday 9am - 1pm

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Paymentshield Limited (registered number 02728936) is a company registered in England and Wales at Southport Business Park, Wight Moss Way, Southport, PR8 4HQ. Telephone calls may be recorded for security purposes and monitored under our quality control procedures.

Paymentshield Limited is authorised and regulated by the Financial Conduct Authority (FCA) under registration No. 312708.See the Financial Services Register for further details.