PLEASE COMPLETE AS FULLY AS POSSIBLE - QUESTIONS MARKED * MUST BE ANSWERED
you are not under any obligation by completing this form
1. *Amount of loan/mortgage required
2. *Repayment term required select
3. *Purpose of loan (please be specific and detailed)
4. *Name of your Company (if applying as an individual state NONE)
5. *Type of business (ie manufacturing/retail/professional/services etc)

PERSONAL DETAILS
(Primary Applicant)
6. *Full Name
7. *Date of birth
8. *Address
9. *Employment status select
10. If other please specify
11. DAYTIME Telephone Number
12. EVENING Telephone Number
13. MOBILE Telephone Number
14. *Email address (ensure this is accurate – if NONE state NONE)
15. *Have you had any court orders, defaults or debts registered against you. If yes - give brief details, ie amount/date - if NONE State NONE
16. *Have you ever been declared bankrupt or made arrangements with creditors or IVA. If yes - give brief details, ie amount/date - if NONE State NONE































JOINT APPLICANTS
(if there are no other applicants ignore this question)
17. Name of Joint applicant
18. Age
19. Name of Joint applicant
20. Age
21. Name of Joint applicant
22. Age

PROPERTY DETAILS
(property to be used as security)
23. *Full Address of property (including postcode)
24. *Brief description of property (ie Shop/hotel/pub/offices/factory etc)
25. *Tenure select
26. If Leasehold, number of years remaining
If You Already Own Your Business Property – Complete Below
27. Date of purchase
28. Price Paid
29. Estimated Value (bricks/mortar)
30. Amount owing on present mortgage
31. Name of Mortgage Company
If Purchasing This Property
32. Purchase price





























ADDITIONAL SECURITY
(If you have NO additional property ignore this section)

If you have other property such as your own or business premises this can be used as additional security, we can then maximise our advance to you – complete below
33. Full Address of property (including postcode)
34. Brief description of property (ie Shop/hotel/pub/offices/factory etc)
35. Tenure
36. If Leasehold, number of years remaining
37. Date of purchase
38. Price Paid
39. Estimated Value (bricks/mortar)
40. Approximate sum owing on mortgage
41. Name of Mortgage Company (If you have a mortgage)

NOTES
Please write below any information you think relevant to your application
Where did you hear about us?
Statement: In sending this information you warrant the information stated to be correct and
understand it will form the basis of any agreement. I/we have read the information below.
Please click only the 'Send Application' button once, it may take a few seconds to process your details.

Disclosure & Use Of Your Information

It is important you read the information in our Data Protection notice, this explains how your data will be used.

I/we confirm that the information given in this application is accurate and that you, or any related finance/ mortgage company to whom you submit this application, may use and disclose my/our data as described in the Data Protection notice.

Unless you tick the box below both we and any other related finance / mortgage company we may refer your application to, may write to you offering products which we or they feel may be of interest to you.

I/we do not wish to receive correspondence from you offering other products which you think may be of interest to me/us.