You can always press Enter⏎ to continue
Customer Referral to Land Logic
Please provide contact details for your client.
START
1
Unique_ID
Previous
Next
Submit
Press
Enter
2
Your Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
3
Your Email
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
4
Is the Valuation For a Bank?
*
This field is required.
Yes
No
Previous
Next
Submit
Press
Enter
5
Bank
*
This field is required.
ANZ Bank (Vanuatu) Limited
Bank South Pacific (Vanuatu) Limited
BRED (Vanuatu) Limited
National Bank of Vanuatu Limited
Wanfuteng Bank Limited
Previous
Next
Submit
Press
Enter
6
Customer's Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
7
Customer's Phone Number
We prefer email, but if the client doesn't have email, please give phone number. We will call them to discuss the quote.
Phone Number
Previous
Next
Submit
Press
Enter
8
Customer's Phone Number
We prefer email, but if the client doesn't have email, please give phone number. We will call them to discuss the quote.
Area Code
Phone Number
Previous
Next
Submit
Press
Enter
9
Customer's Email
example@example.com
Previous
Next
Submit
Press
Enter
10
Title Number(s)
Enter the title number(s) to be included in the valuation
Title Number
Title Number
Title Number
Title Number
Title Number
Title Number
Previous
Next
Submit
Press
Enter
11
Attach any supporting documents
Example: builder & engineer drawings, lease, survey
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
Cancel
of
Previous
Next
Submit
Press
Enter
12
Any further instructions or comments?
Please give any additional information you feel is important for us and the Valuer to know.
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
12
See All
Go Back
Submit