[% SET bodyclass = 'formflow' %] [% USE date(format = '%A, %-d~~~ %B') ~%] [% PROCESS 'govuk/fields.html' ~%] [% INCLUDE header.html %] [% PROCESS errors %] [% SET data = form.saved_data ~%]

[% form.title %]

Please review all information provided and make sure all is correct and all documents attached before submitting your claim.

[% summary_title %]
[% FOR page IN form.fields_for_display %] [% NEXT IF page.hide %]
[% page.title %]
[% FOR field IN page.fields %] [% NEXT IF field.hide %]
[% field.desc %]
[% IF field.type == 'Photo' %] [% SET photos = field.value.split(','); FOR photo IN photos ~%] [% END ~%] [% ELSE %] [% field.pretty %] [% END %]
[% END %] [% END %]

A copy of the above will be emailed to you, but you may also wish to save or print a copy of this page for your records.

[% PROCESS form %]
[% INCLUDE footer.html %]