Loans Enquiry Form
Please Complete the form below as accurately as possible
THE  LOAN
Type of Loan Required:
Loan amount required:
Loan Term (months):
Purpose of loan:
 
PERSONAL DETAILS
Status:
Title:
First name(s):
Surname:
Date of birth:
Partner's first name(s):
Surname:
Date of birth:
Your address:


Post Code:
Time at this address (Years):
Telephone (including STD):
Your Email Address:
Previous address if you have lived for less than three years at your current address
 
 
 
PAYMENT PROTECTION
I/We would like my/our loan covered by Life Insurance, Accident, Sickness and also Redundancy Cover. (If self-employed an equivalent alternative package is available.)
Please indicate level of cover required
 
Where I/We have opted not to have a Protected Payment Plan, I/We understand that it is my/our responsibility to keep up the payments if I/We am/are unable to work.
 
 
YOUR WORK
(Note: if you are self-employed please state occupation and how long trading.)
Employer's name:
Time employed by them (Years):
Occupation:
Partner's employer's name:
Time employed by them (Years):
 
 
ABOUT YOUR HOME
Total monthly mortgage payment:
Approximate amount outstanding:
Total arrears (if any):
Highest arrears in the last 12 months (if any)
 
Original amount borrowed on mortgage (including all further advances)
 
The name of the company you have your mortgage with
 
Address of office dealt with:
Mortgage account number:
The name of the Bank or Building Society you use
Name:
Account open (Years):
Current Account No:
Sort Code:
Is you home a:
Is it:
Number of bedrooms:
Number of reception rooms:
Year bought:
What is it worth now?
The amount you paid for your home
 
Is it owned by:
 
 
YOUR INCOME
Your gross income with overtime and any bonuses (if self-employed your net income).
Gross:
Per:
Your partner's gross income with overtime etc.
Gross:
Per:
If self-employed can you supply accounts?
 
Yes No

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to do a credit search?

   
You voluntarily choose to provide personal details to us via this website. Personal information will be treated as confidential by us and held in accordance with the Data Protection Act 1998. You agree that such personal information may be used to provide you with details of services and products in writing, by e-mail or by telephone.