Loan amount (minimum £25,000.00):

£

Loan term:

When do you want the loan?

What is the purpose of the loan?

Exit strategy 1 - How do you intend to repay?

If "other" please specify:

Exit strategy 2 - Do you have one if your preferred option does not work out?

Please specify:

Interest:

Do you have your own solicitors?

Solicitor company:

Solicitor name:

Solicitor Phone Number:

Name:

Your surname:

Date of birth:

Email:

Landline:

Mobile:

Profession:

Annual earnings, income and dividend:

£

Marital status:

Are you applying as a limited company?

Residential postcode:

Residential address (for correspondence):

Time at address:

Is this your residential address?

Property type:

Estimated value:

£

Amount outstanding:

£

What charge will we hold?

Who holds the first charge?

Tenure:

Remaining term on lease?

Who lives at the property?

Who owns the security?

Current status of security?

Number of bedrooms:

Are you in any arrears on this property?

By how much?

£

Have you had a recent valuation?

Please attach if possible:

Security address:

How many other properties / securities do you own?

What is your estimated credit history? (don’t worry, we are not doing any checks without your approval):

Are you in any mortgage arrears?

Are any of your payments in arrears?

Have you ever been bankrupt?

Please add any other information that is relevant to your application:

A: Loan details

B: Personal details

C: Security details

Second security details:

Third security details:

Forth security details:

D: Credit history

E. Introducers & Brokers