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Confidential secured loan application form

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Please complete ALL fields of the form. If any questions do not apply, please put N/A in the relevant boxes.

If you need any advice or help filling in this form please call 08450 657595.

Please note that our loans are for homeowners/mortgage payers only and are secured on property.
 

Your personal details
Applicant 1 Applicant 2
Title Title
Full name Full name
Date of birth Date of birth
Present address
Present address
Post code Post code
If you have been living at your current address less than 3 years, please provide your previous addresses in the box below
 If you have been living at your current address less than 3 years, please provide your previous addresses in the box below
Landline telephone number Landline telephone number
Mobile phone number Mobile phone number
Best time to call Best time to call
E-mail address E-mail address

Income and Occupation details
Applicant 1 Applicant 2
Occupation Occupation
Are you Are you
Length of time in current employment
Length of time in current employment
Gross income £ Gross income £
Is income provable? Yes    No Is income provable? Yes    No

Property details
Date of purchase Is it your first purchase? Yes     No
If it is not your first purchase, when did you finish your last mortgage?

If the property was bought under the Right to Buy scheme please state
Purchase price £     Council valuation £

Is the property standard construction? Yes     No     If No, what is it built of?

If it is a flat, what floor is it?    How many floors are in the block?
Is the property ex-council? Yes     No  
Property purchase price £    Current  valuation £

Your mortgage details
Present lender
Present mortgage balance £ Monthly mortgage payment £
Current arrears
Reason for arrears

Loan requirements
Amount required £ Term in years
Purpose of loan Repayment          Interest only

Any additional information


Think carefully before securing other debts against your home.
Your home may be repossessed if you do not keep up repayments on a mortgage.

By submitting this application you confirm that you have read and accept
the Borrowers Declaration and Data Protection statement.
 



 


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