Individual profile form (NS2) First & Middle names Surname (include maiden) Date of birth (dd/mm/yyyy) Nationality (if dual state all) Residential address Name / House number Street Town / City Parish/County/State Country Postcode Telephone number Mobile number Email address How did you hear about Parslows? WebsiteSocial MediaReputationRepeat BusinessReferalRadio 103Liberty BusChamber NewsletterAgent Bank AccountName of account holder Bank name Sort code Account number Verification DocumentsParslows will require the documents set out below. These documents are required to verify your identitiy.Verification of identityPlease provide one of the following. Tick beside document provided and return with this form (no requirement for document to be certified).Copy of your current passportCopy of your current national identitiy card (bearing a photograph of you)A copy of your driving licence (bearing a photo of you)Verification of addressPlease provide one of the following and tick beside the document provided (must be dated within three months - no requirement for document to be certified)Copy of a utility billCopy of a bank statementCopy of government department/ agency/ tax office correspondenceTenancy contract or agreementI understand and accept that any information and or documentation I provide to Parslows in connection with the legal engagement by their client(s) may be subject to disclosure and or production pursuant to orders having legal effect in Jersey. Moreover, pursuant to anti-money laundering laws and or court proceedings, in certain circumstances Parslows may be required to disclose information and or documentation concerning me to third parties such as, but not limited to, banks providing services to such client(s) and/or to intermediaries. I indemnify Parslows for any responsibility and or liability arising directly and or indirectly as a result of such disclosure.I consent to the disclosure of information and or documentation as set out above.