Secured Loans
About Your Loan  
Amount Required Term (months/years)
Purpose of Loan Payment protection cover required for one or both applicants? Single cover
Doublecover
About You
Are you: Married
Single
Divorced Widowed Separated
First applicants full name(s) D.O.B
Second applicants name(s) D.O.B
Current Address
How long at this address Home Telephone
Number of children under 18 Mobile
Previous Address
About Your Income
First Applicant, are you: self employed employed
Occupation
How long in the job
Employers Name and Address
Second Applicant, are you: seld employed employed
Occupation
How long in the job
Employers Name and Address
First applicants bank details time bank account held
Bank name/ address
If self employed, Accountants name and address
First Applicants total gross income before deductions
Second applicants total gross income before deductions
Other income
About your Mortgage
Approximate £ outstanding
Total Monthly payments
Total arrears (if any)
Mortgage
Second mortgage or other loan secured on property
Mortgage lender's name/ address
Mortgage Account Number
Highest arrears in last 12 months (if any) When did they occur?
If applicable name and address of second lender
Mortgage account number
Have you ever had any count court judgements Yes No Is, how many
Notes
About your Property
Bungalow
Flat
If flat, how many floors
Maisonette
Terraced
Semi
Detached
Shared Ownership Yes No
No. of bedrooms
Reception rooms
Bathrooms
Garage Yes No
Is it
freehold
leasehold
if leasehold, no. of years left on the lease
Constuction
Year built
Date of purchase
Purchase price
Estimated Value now
Major alterations since purchase
NB Please enclose a copy of the latest Property Valuation if available.
Did you purchase your property as an ex-council house yes No
If 'No' was property formally owned by the council? yes No
If 'Yes' what value did the council place on the property at the time of purchase?
How much discount were you given?
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