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About
Amount of Loan
Please choose
£1,000
£1,500
£2,000
£2,500
£3,000
£3,500
£4,000
£4,500
£5,000
£5,500
£6,000
£6,500
£7,000
£7,500
£8,000
£8,500
£9,000
£9,500
£10,000
£10,500
£11,000
£11,500
£12,000
£12,500
£13,000
£14,000
£15,000
£16,000
£17,000
£18,000
£19,000
£20,000
£21,000
£22,000
£23,000
£24,000
£25,000
£26,000
£27,000
£28,000
£29,000
£30,000
£31,000
£32,000
£33,000
£34,000
£35,000
£36,000
£37,000
£38,000
£39,000
£40,000
£45,000
£50,000
£55,000
£60,000
£65,000
£70,000
£80,000
£90,000
£100,000
£110,000
£120,000
£130,000
£140,000
£150,000
£160,000
£170,000
£180,000
£190,000
£200,000
£210,000
£220,000
£230,000
£240,000
£250,000
Purpose of Loan
Please choose
Consolidation
Home Improvement
Holiday
Furniture
Electrical Equipment
Medical Fees
Christmas
Car
Remortgage
Mortgage
Status
Please choose
Homeowner with mortgage
Outright Homeowner
Tenant
About you
Repayment Period:
yrs
Have you got permanent resident rights in the UK?
Yes
No
Residential Status:
- Select -
Homeowner with mortgage
Own home outright
Student Acc.
Tenant
Living w/parents
Loan Purpose:
-Please Select-
Car Loan
Home Improvement
Consolidation
Holiday
Overdraft
Mortgage
Remortgage
Business Loan
Other
Loan Amount:
£7,500
£8,000
£9,000
£10,000
£11,000
£12,000
£13,000
£14,000
£15,000
£16,000
£17,000
£18,000
£19,000
£20,000
£25,000
£30,000
£35,000
£40,000
£45,000
£50,000
£55,000
£60,000
£65,000
£70,000
£80,000
£90,000
£100,000
£100,000+
Title and First Name:
--
Mr
Mrs
Miss
Ms
Surname:
Date Of Birth:
dd
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
mm
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
yyyy
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
Mother's Maiden name:
Job Status:
- Select -
Full Time
Part Time
Self Employed
Retired
Unemployed
Homemaker
Occupation:
Yearly Income:
- Select -
£1,000
£2,000
£3,000
£4,000
£5,000
£6,000
£7,000
£8,000
£9,000
£10,000
£11,000
£12,000
£13,000
£14,000
£15,000
£16,000
£17,000
£18,000
£19,000
£20,000
£21,000
£22,000
£23,000
£24,000
£25,000
£26,000
£27,000
£28,000
£29,000
£30,000
£31,000
£32,000
£33,000
£34,000
£35,000
£36,000
£37,000
£38,000
£39,000
£40,000
£41,000
£42,000
£43,000
£44,000
£45,000
£46,000
£47,000
£48,000
£49,000
£50,000
£51,000
£52,000
£53,000
£54,000
£55,000
£56,000
£57,000
£58,000
£59,000
£60,000
£61,000
£62,000
£63,000
£64,000
£65,000
£66,000
£67,000
£68,000
£69,000
£70,000
£71,000
£72,000
£73,000
£74,000
£75,000
£76,000
£77,000
£78,000
£79,000
£80,000
£81,000
£82,000
£83,000
£84,000
£85,000
£86,000
£87,000
£88,000
£89,000
£90,000
£91,000
£92,000
£93,000
£94,000
£95,000
£96,000
£97,000
£98,000
£99,000
£100,000
Job Length:
- Select -
< 1 year
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years
21 years
22 years
23 years
24 years
25 years
26 years
27 years
28 years
29 years
30 years
30+ years
Years with bank
- Select -
< 1 year
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years
21 years
22 years
23 years
24 years
25 years
26 years
27 years
28 years
29 years
30 years
30+ years
Any additional income?
No
£1,000
£2,000
£3,000
£4,000
£5,000
£6,000
£7,000
£8,000
£9,000
£10,000
£11,000
£12,000
£13,000
£14,000
£15,000
£16,000
£17,000
£18,000
£19,000
£20,000
£21,000
£22,000
£23,000
£24,000
£25,000
£26,000
£27,000
£28,000
£29,000
£30,000
£31,000
£32,000
£33,000
£34,000
£35,000
£36,000
£37,000
£38,000
£39,000
£40,000
£41,000
£42,000
£43,000
£44,000
£45,000
£46,000
£47,000
£48,000
£49,000
£50,000
£51,000
£52,000
£53,000
£54,000
£55,000
£56,000
£57,000
£58,000
£59,000
£60,000
£61,000
£62,000
£63,000
£64,000
£65,000
£66,000
£67,000
£68,000
£69,000
£70,000
£71,000
£72,000
£73,000
£74,000
£75,000
£76,000
£77,000
£78,000
£79,000
£80,000
£81,000
£82,000
£83,000
£84,000
£85,000
£86,000
£87,000
£88,000
£89,000
£90,000
£91,000
£92,000
£93,000
£94,000
£95,000
£96,000
£97,000
£98,000
£99,000
£100,000
Marital Status:
- Select -
Single
Married
Divorced
Widowed
Seperated
Living Together
Number of children:
- Select -
0
1
2
3
4
5
6
7
8
Maiden Name:
Proof of income:
- Select -
2 yrs Cert/Chartered Accts
Self Certification
Accountants Letter
Source of additional income:
Partner Information
First Name:
Mr
Mrs
Miss
Ms
Surname:
Date Of Birth:
dd
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
mm
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
yyyy
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
Job Status:
- Select -
Full Time
Part Time
Self Employed
Retired
Unemployed
Homemaker
Yearly Income:
- Select -
£0
£1,000
£2,000
£3,000
£4,000
£5,000
£6,000
£7,000
£8,000
£9,000
£10,000
£11,000
£12,000
£13,000
£14,000
£15,000
£16,000
£17,000
£18,000
£19,000
£20,000
£21,000
£22,000
£23,000
£24,000
£25,000
£26,000
£27,000
£28,000
£29,000
£30,000
£31,000
£32,000
£33,000
£34,000
£35,000
£36,000
£37,000
£38,000
£39,000
£40,000
£41,000
£42,000
£43,000
£44,000
£45,000
£46,000
£47,000
£48,000
£49,000
£50,000
£51,000
£52,000
£53,000
£54,000
£55,000
£56,000
£57,000
£58,000
£59,000
£60,000
£61,000
£62,000
£63,000
£64,000
£65,000
£66,000
£67,000
£68,000
£69,000
£70,000
£71,000
£72,000
£73,000
£74,000
£75,000
£76,000
£77,000
£78,000
£79,000
£80,000
£81,000
£82,000
£83,000
£84,000
£85,000
£86,000
£87,000
£88,000
£89,000
£90,000
£91,000
£92,000
£93,000
£94,000
£95,000
£96,000
£97,000
£98,000
£99,000
£100,000
Job Length:
- Select -
< 1 year
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years
21 years
22 years
23 years
24 years
25 years
26 years
27 years
28 years
29 years
30 years
More than 30 years
Primary Phone Number:
UK Resident?
Yes
No
Maiden Name :
Your Address & Contact Details
No. & Street:
Postcode:
Time At House:
- Select -
3 or More Years
Less than 3 years
Email:
Home Phone:
Mobile Phone:
Property Type:
- Select -
Detached
Semi Detached
Mid Terrace
End Terrace
Bungalow
Flat
Other
Bedrooms:
--
1
2
3
4
5
6
7
8
9
10+
Type of Walls:
- Select -
Bricks & mortar
Concrete panels
Concrete poured
Mobile home
Steel framed
Stone
Timber framed
Best Contact Time:
8:00
9:00
10:00
11:00
12:00
13:00
14:00
15:00
16:00
17:00
18:00
19:00
20:00
today
1 days time
2 days time
3 days time
4 days time
5 days time
6 days time
How Many Storeys?
- Select -
1
2
3
4
5
6
7
8
9
10
10 or more
Previous Address:
No. & Street:
Postcode:
Previous mortgage?
- Select -
no
yes
About your Mortgage
Property Value:
- Select -
£50,000
£60,000
£70,000
£80,000
£90,000
£100,000
£110,000
£120,000
£130,000
£140,000
£150,000
£160,000
£170,000
£180,000
£190,000
£200,000
£210,000
£220,000
£230,000
£240,000
£250,000
£260,000
£270,000
£280,000
£290,000
£300,000
£310,000
£320,000
£330,000
£340,000
£350,000
£360,000
£370,000
£380,000
£390,000
£400,000
£410,000
£420,000
£430,000
£440,000
£450,000
£460,000
£470,000
£480,000
£490,000
£500,000
£510,000
£520,000
£530,000
£540,000
£550,000
£560,000
£570,000
£580,000
£590,000
£600,000
£610,000
£620,000
£630,000
£640,000
£650,000
£660,000
£670,000
£680,000
£690,000
£700,000
£710,000
£720,000
£730,000
£740,000
£750,000
£760,000
£770,000
£780,000
£790,000
£800,000
£810,000
£820,000
£830,000
£840,000
£850,000
£860,000
£870,000
£880,000
£890,000
£900,000
£910,000
£920,000
£930,000
£940,000
£950,000
£960,000
£970,000
£980,000
£990,000
£1,000,000
Mortgage Balance:
- Select -
£1,000
£2,000
£3,000
£4,000
£5,000
£6,000
£7,000
£8,000
£9,000
£10,000
£15,000
£20,000
£25,000
£30,000
£35,000
£40,000
£45,000
£50,000
£60,000
£70,000
£80,000
£90,000
£100,000
£110,000
£120,000
£130,000
£140,000
£150,000
£160,000
£170,000
£180,000
£190,000
£200,000
£225,000
£250,000
£275,000
£300,000
£325,000
£350,000
£375,000
£400,000
£425,000
£450,000
£475,000
£500,000
£525,000
£550,000
£575,000
£600,000
£625,000
£650,000
£675,000
£700,000
£725,000
£750,000
£775,000
£800,000
£825,000
£850,000
£875,000
£900,000
£925,000
£950,000
£975,000
£1,000,000
Monthly Payments:
- Select -
None
£50
£100
£150
£200
£250
£300
£350
£400
£450
£500
£550
£600
£650
£700
£750
£800
£850
£900
£950
£1,000
£1,100
£1,200
£1,300
£1,400
£1,500
£1,600
£1,700
£1,800
£1,900
£2,000
£2,100
£2,200
£2,300
£2,400
£2,500
£2,600
£2,700
£2,800
£2,900
£3,000
£3,500
£4,000
£4,500
£5,000
£5,500
£6,000
£6,500
£7,000
£7,500
£8,000
Purchase Price:
- Select -
£50,000
£60,000
£70,000
£80,000
£90,000
£100,000
£110,000
£120,000
£130,000
£140,000
£150,000
£160,000
£170,000
£180,000
£190,000
£200,000
£210,000
£220,000
£230,000
£240,000
£250,000
£260,000
£270,000
£280,000
£290,000
£300,000
£310,000
£320,000
£330,000
£340,000
£350,000
£360,000
£370,000
£380,000
£390,000
£400,000
£410,000
£420,000
£430,000
£440,000
£450,000
£460,000
£470,000
£480,000
£490,000
£500,000
£510,000
£520,000
£530,000
£540,000
£550,000
£560,000
£570,000
£580,000
£590,000
£600,000
£610,000
£620,000
£630,000
£640,000
£650,000
£660,000
£670,000
£680,000
£690,000
£700,000
£710,000
£720,000
£730,000
£740,000
£750,000
£760,000
£770,000
£780,000
£790,000
£800,000
£810,000
£820,000
£830,000
£840,000
£850,000
£860,000
£870,000
£880,000
£890,000
£900,000
£910,000
£920,000
£930,000
£940,000
£950,000
£960,000
£970,000
£980,000
£990,000
£1,000,000
Date Purchased:
Mortgage Company:
Mortgage Type:
- Select -
Repayment
Endowment
Interest Only
Deferred
Other
Term Left:
yrs
Any Arrears?
---
No
Yes
Existing Secured Loans?
No
Yes
Did you purchase as a sitting tenant?
- Select -
No
Yes
Additional Info
What did the council value the property at
for the purchase?*
What discount did you receive from the council?*
Arrears
Present Arrears?
Highest Arrears in last 12 months?
Last 3 payments on time?
No
Yes
Other Secured Loans
Secured Loan Company:
Loan Amount Owed:
Please verify that you've read and agree to all the terms
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