Survey Information Survey Type Survey Type RICS Home Survey Level 2 RICS Home Survey Level 3 Property Value Range Property Value Range Below £150,000 Between £150,00 - £200,000 Between £200,00 - £250,000 Between £250,00 - £300,000 Between £300,00 - £400,000 Between £400,00 - £500,000 Between £500,00 - £600,000 Above £600,00 Cost of Survey(£) Personal Information Title Your Title Mr Mrs Ms Dr Prof F_Name L_Name Correspondence Address Email Address Their Phone Number Property Details Property Address (1st Line) Property City/Town Property City/Town Blaenau Gwent Bridgend (Pen-y-bont ar Ogwr) Caerphilly (Caerffili) Cardiff (Caerdydd) Carmarthenshire (Sir Gaerfyrddin) Merthyr Tydfil (Merthyr Tudful) Monmouthshire (Sir Fynwy) Neath Port Talbot (Castell-nedd Port Talbot) Newport (Casnewydd) Pembrokeshire (Sir Benfro) Powys Rhondda Cynon Taf Swansea (Abertawe) Torfaen (Tor-faen) Vale of Glamorgan (Bro Morgannwg) Property Post Code Property Value Specific areas of concern Estate Agent Details Estate Agent Estate Agent Address (1st Line) Estate Agent Post Code Terms - Location - Agreement I agree to the following: RICS Home Survey Level 3 Terms and Conditions or the RICS Home Survey Level 2 terms and conditions or the Condition Report Terms and Conditions. The above property is located within the area covered by Welsh Counties Surveys Ltd and all information is correct. Payment will be made in full (via PayPal or bank transfer) and form part of this formal instruction as per the information provided above. Signature Type name for Signature Date Proceed to Payment