Change of Broker Form
Please Fax this form to St James International Client Services on + 34 952 799 425, and post the original to the address below.
	Postal Address:
	Post Code:
	Telephone Number:
	Date:
	Dear Sirs
	Re: Policy No
	Financial Institution:
	With effect from the above date I should like servicing of the above plan(s) to be changed to:
	St James International Administration Centre 6 y 7 Plaza de los Faroles Pasaje las Palmeras San Pedro de Alcántara 29670 Marbella, Málaga Spain Telephone: + 34 952 799 616 Facsimile: + 34 952 799 425 email: stji@stjamesinternational.com website: www.stjamesinternational.com
	Yours faithfully
	SIGNED  ...............................................
	Name of account holders(s):
St James International will not disclose your details to any third party or use your details for any purpose other than that for which they are supplied.