Loan Amount Requested:* (between £10,000 and £20,000,000)
Loan Term (years):*
Purpose:*
Single or Joint Application:
SingleJoint
Title:
Forename(s):*
Surname:*
Date of Birth: *
Marital Status:
Security Address: *
Residential address (if different from security address):
Time at this address:*
Previous address if less than 3 years:
Primary Contact Number:*
Alt Contact Number:
Email Address:*
Number of dependents:
Any CCJ's or Defaults Registered:
NoYes
Number:
Value: £
Bankruptcy:
IVA:
DMP:
Occupation:
Employed or Self-employed?
EmployedSelf-Employed
How long with current employer/self-employed?
Employers name & address:
If self-employed, net profit per annum? £
Name, address & telephone number of accountant:
Gross Salary: £
Is overtime/bonus paid regularly:
YesNo
If yes, give amount: £
Any other income?
Loans: £
HP: £
Credit Cards: £
Forename(s):
Surname:
Date of Birth:
Security Address:
Time at this address:
Primary Contact Number:
Email Address:
Name of Lender:
Balance: £
Monthly repayments: £
Current arrears? £
Highest arrears in last 12 mths? £
Is mortgage in both applicants name?
Remortgaged in the last 12 mths?
Note: If remortgaged in the last 12 months please give the following details:
Name of previous lender:
Address of previous lender:
Additional Notes:
Date of purchase:
Purchase price: £
What tenure is the property?
Unexpired lease:
Present value: £
Was the property purchased from the Local Council/Housing Association?
What the Council/Housing Association valuation?
Type of Property:
Number of Bedrooms:
If flat, how many floors in block?
What is the property built of?
Is the property let?
Additional notes:
TO PROCEED WE REQUIRE THE APPLICANT/S CONSENT TO THE INFORMATION BELOW. PLEASE CONFIRM THE FOLLOWING STATEMENTS HAVE BEEN READ
Under the Data Protection Act I need to inform you what will happen with the information you provide. second-charge-loans shall use it to obtain credit reference agency searches which may affect your credit rating.
Your information will also be used for underwriting and processing your finance application. It will be kept on their computer systems and files. The information given may be recorded with one or more credit reference agencies, used by second-charge-loans, their lenders or other companies for making credit decisions about you.
Do we have the permission to do a credit search and storage of personal information?