Response formCase number1Claimant’s

Response formCase number1Claimant’s name1.1Claimant’s name2Respondent’s details2.1*Name of individual, company or organisation2.2Name of contact2.4Phone numberWhere we can contact you during the dayMobile number (If different)2.5How would you prefer us to contact you?(Please tick only one box)EmailPostFaxWhatever your preference please note that some documents cannot be sent electronically2.6Email addressFax number2.7How many people does this organisation employ in Great Britain?2.8Does this organisation have more than one site in Great Britain?YesNo2.9If Yes, how many people are employed at the place where the claimant worked?ET3 - Response form (04.14) © Crown copyright 20142.3*AddressNumber or nameStreetTown/CityCountyPostcodeDX number (If known)You must complete all questions marked with an