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Horizon Convictions Redress Scheme:
Preliminary payment application form
You must answer every question on this form to the best of your knowledge and belief. We
cannot progress your redress payments without the information requested here.
You will need to complete this form and have your identity verified to receive payment. We
will explain to you or your solicitor what is required to verify your identity.
Once completed, please send the form to.
horizonconvictionsredres:
Applicant details
Applicant full name
The applicant is the person who was
previously convicted.
Scheme Unique Reference Number
(URN)
Your URN is on the letter informing you
that your conviction has quashed. If
you have not received a letter, you will
need to register for the scheme to
receive your URN.
Bank details Name on account:
Please provide the details for where
you want the preliminary payment to be
sent.
Please note, it is scheme policy to pay
redress payments directly to the person I Account number:
entitled to redress and therefore we will
not pay this money into a solicitor’s
client account.
Sort code:
Linked applications
Have you submitted an application
already to another Post Office related
scheme, for example:
¢ — Horizon Shortfall Scheme
¢ — Overturned Convictions
process
e Group Litigation Order scheme
« — Suspension Remuneration
Review
If yes, please confirm which scheme.
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Linked applications with another
Are you related to somebody who has
made an application to in any of the
Horizon Redress Schemes, i.e.:
e the Horizon Convictions
Redress Scheme
¢ the Horizon Shortfall Scheme
e the Overturned Convictions
process
e — the Group Litigation Order
Scheme
This might be a family member, spouse
(even if separated) or business partner,
etc.
If yes, please provide their full name
and which scheme they have applied to
(if known).
Bankruptcy details
Were you declared bankrupt or subject to an Individual Voluntary Arrangement (IVA)?
* Yes * No
If YES, please provide the details requested below:
This is so that we can contact your trustee in bankruptcy to confirm that they will not claim
any part of your redress payment to pay creditors, so long as your bankruptcy was
discharged before the date of your conviction was overturned. If you entered an IVA, we
will contact the supervisor.
Fill for bankruptcies
Your trustee in
bankruptcy — the name
and contact details
The date you were
declared bankrupt
Has your bankruptcy
been discharged? Please
provide the date
Fill for Individual Voluntary Arrangements (IVAs)
Your IVA supervisor — the
name and contact details
The date you entered
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into an IVA
Has the IVA completed?
Please provide the date
Declaration regarding your application
Background
The Post Office (Horizon System) Offences Act 2024 and the Post Office (Horizon
System) Offences (Scotland) Act 2024 were passed in light of fundamental problems in
the Post Office investigation and prosecution process. That process included relying on
flawed computer evidence, inappropriate interviews, failure to disclose and investigate
Horizon issues and unfair pressure to admit dishonesty offences, such as false
accounting.
Declaration
By signing this document, I confirm that:
I am applying for financial redress because of damage suffered (financial and/or
personal) by either:
* — me, the wrongly convicted person (applying for myself) or
e the wrongly convicted person whom I am representing (applying for someone
else) for whom I have lawful authority to act; or
¢ — the estate of a wrongfully convicted person in respect of which I have authority to
act
due to Horizon shortfalls [and/or] the prosecution [and/or] the investigation [and/or]
conduct by the Post Office.
I understand that if I give false or misleading information in support of my application or
make a fraudulent application I may:
* — be subject to court proceedings
e have to re-pay any money I was not entitled to
This section needs to be signed by the person whose conviction has been quashed (the
applicant).
If the applicant is dead, the person with legal authority to administer their estate can sign on
behalf of the estate.
If the applicant is incapacitated, the person with the legal authority to act on their behalf can
sign on their behalf.
A solicitor supporting with the application cannot sign this declaration on the applicant's
behalf.
Signed
Print name
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Date
Once completed, please sen
horizonconvictionsredress_
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