Money Enquiry Form | Citizens Advice Bureau

How we use your information

When we record and use your personal information we: Only access it when we have a good reason; Only share it when it is necessary and relevant; and we don\’t sell it to commercial organisations.

We need to record information about you to help with your enquiry. We have a legitimate interest to do this. Please let us know if you would like more information about how we use your data.

Special Category Data *

To record any information about the following, you will need to give explicit consent. (please tick any that apply) We will only ask about these categories of data when they relate to your enquiry, or for us to try and improve our service or produce anonymous reports. We will still advise if you do not consent to this, however if any of this information is important to your enquiry (for example health benefits) then this may limit how much we can assist or how much detail we can go into.

Ethnicity

Health Conditions

Religion

Sexual Orientation

Trade Union Membership

None of the above

Title:

First Name:

Last Name:

Type of query:

Have you any deadlines (threatened action/disconnection/reply by dates)

Please tell us about your creditors (Who do you owe money to and how much)

Please give details of your question: *

What have you done so far?

What would you like us to do for you?

Address:

Apt, suite, etc.

Country

City

State

Zip code

Date of Birth:

Email Address: *

By providing the email address we consider you are consenting to be contacted via email

Do you have difficulties communicating in English?

Yes

We cannot send email responses in another language. If you need an interpreter please call 0800 144 8848 (Monday-Friday 9:00am-4:00pm and we can provide an interpreter for you

How did you hear about us? *

CAB Data Protection Statement *

I have read the above paragraph, I agree and give my consent to the Citizens Advice Service.

I have agreed the Personal Data Protection.

In order to help you we need to store information about you. The law says we must get your consent to do this. Everything you tell us will be treated confidentially. The information we hold on you will be used solely for the purposes of enabling us to provide you with an effective service. You have the right to make a formal request in writing for access to personal data we hold on you, and to have it corrected if it is wrong. We will not disclose information about you unless the law permits us to, or we have obtained your consent to do so.I have read the above paragraph, I agree and give my consent to the Citizens Advice service

Third Party Referral *

““By ticking the consent box you (the third party) have obtained consent from your client and agreed a referral to Coventry Citizens Advice, who may be able to help with the issues above. Coventry Citizens Advice will now contact you in due course.”

If you are completing this form for yourself, please click the box below and move onto the Data Protection Statement. If you are a third party and are referring a client to our service, we will need the client to verify their consent to the referral.

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