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Loan application
Is this application via a introducer or broker?
Yes
No
A. Introducer Details
Name:
Telephone number:
Email address:
B. Applicants Details
Title: *
Please select
Mr
Mrs
Ms
Miss
Dr
Surname: *
First name(s): *
Date of birth:
Day
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/
Month
January
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/
Year
1994
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Address line 1:
Address line 2:
Town / City: *
County:
Postcode: *
Telephone number: *
Email address: *
C. Additional Applicants (Please provide income and employment details)
Are there any additional applicants? *
Yes
No
D. Income and employment details
Occupation: *
Employer: *
Employer's address: *
Employer's telephone number: *
Type of contract: *
Permanent
Temporary
Fixed term
Current basic annual income (gross): *
£
Any other income:
£
Total income: *
£
E. Financial details
Have you ever been bankrupt, insolvent or sequestrated, or had a property repossessed? *
Yes
No
Have you ever had a court judgement or decree registered against you, or are you aware of any summons pending or that has recently been served? *
Yes
No
Have you ever made any special arrangements to clear a
debt? *
Yes
No
F. Property details
Address of property to secure the loan:
Address line 1: *
Address line 2:
Town / City: *
County:
Postcode: *
Estimated value: *
£
Purchase price: *
£
Loan required: *
£
Will this be your main residence? *
Yes
No
Purpose of loan: *
How do you intend to repay the bridging loan? *
Additional information / comments
Has a signed credit search authority been obtained?*
Yes
No
How did you hear about us? *
Please select
Search engine
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Article - print
Article - web
Company website
Direct mail
Seminar
Tradeshow
Friend / colleague
Other