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					          NEW LEAF DISTRIBUTION SUBMISSION SHEET
The Submission Sheet is intended to be completed electronically, as “master” drop-down values have been
provided in order to ensure consistency and quality of the data.
The Submission Sheet should be Emailed and/.or faxed to the NLD Administrator as follows:
Email: gill.richardson@nlgfs.com or Fax: 01702 334475
(NB: The NLD Administrator will complete the NLD Case Ref: numbers)
Appointed Representative:

Broker:
Client Name(s):
Client 1:

Client 2:
Application Date:
Month Submitted: - Select Month -
Date Submitted:
GENERAL INSURANCE:                                                     NLD Case Ref: NLD09
General Insurance Tied Lender: - Select Lender -
General Insurance Source Lender: - Select Lender -
General Insurance DFS: - Select Type -
General Insurance Type: - Select Type -
Buildings & Contents Premium:                          MPPI Premium:
General Insurance Written Commission:
Commission Split: - Select % Split -
Amount (£) to NLD:                               Amount (£) to Broker:
Broker Fee:
PROTECTION PRODUCTS:                                                    NLD Case Ref: NLD09
Protection Lender: - Select Lender -
Protection Type: - Select Type -
Re-Broking Policy: - Select Yes or No -
Life Assured: - Select Life -
Sum Assured:
Term:
Premium:
Protection Written Commission:
Commission Split: - Select % Split -
Amount (£) to NLD:                               Amount (£) to Broker:
Broker Fee:
MORTGAGES:                                                              NLD Case Ref: NLD09
Mortgage PMS - Lender: - Select Lender - - Select Lender - - Select Lender -
Mortgage CMLS – Lender: - Select Lender - - Select Lender -
Mortgage GHL – Packaged: - Select Lender - - Select Lender -
Mortgage Direct – Lender:
Mortgage Category: - Select Category -
Mortgage Payment: - Select Payment Type -
Mortgage Type: - Select Mortgage Type -
Mortgage Certification: - Select Status -
Lending into Retirement: - Select Yes or No -
Purchase Price and/or Value:
Loan Amount:
Mortgage Written Commission:
Commission Split: - Select % Split -
Amount (£) to NLD:                               Amount (£) to Broker:
Broker Fee:                                   NLD “Associated” Solicitors Used: - Select Yes/No -




New Leaf Distribution Submission Sheet v1.12 (Version should be kept aligned with NLD Template)

				
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posted:2/10/2011
language:English
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