Amount to Borrow:

Term of Payment

First Applicant

Second Applicant

First Name

Surname

Title

Residential Address

Postcode

Residential Address
Value (estimate)

Mortgage Amount
Outstanding (estimate)

Mortgage Monthly Payment

Mortgage Lender

Proof of Income
(e.g. Accounts.....etc)

Email

Daytime Tel

Evening Tel

Mobile Tel

Commercial or Semi-Commercial Loan Address

Address

PostCode

Tel. of Business Address

Commercial or Semi-Commercial Property Current Mortgage Details

Estimated Current Value

Estimated Mortgage
Amount Outstanding

Monthly Payment Amount

Mortgage Name

Comments

The information you provide will be used by us for the purposes of assessing your application and retained on our system and may be submitted to Lenders who will use it for the same purpose. It may also be used by us for the subsequent marketing of products and services to you. Telephone calls may be recorded for training and other purposes.

Both we and our lenders will make searches of credit reference agencies who will supply us with credit information, as well as information from the Electoral Register. They will record details of the search whether or not this application proceeds and details of our searches may be seen by other organisations which may make searches in the future. We may use scoring methods to assess this application and to verify your identity. Alternatively, we may ask you to provide physical forms of identification.

Both we and the Lenders may contact third parties, for example your employer or bank, to verify the application details you provide.If you do not qualify for the loan applied for, or we believe that another product may be more suitable for you, we may pass your details to other Lenders or companies who may offer you alternative loan products

All information held about you by the credit reference agencies may be linked to records relating to one or more persons, for example, your spouse, and that for this application you may be treated as linked financially and that we and our lenders will consider any associated record.

Please confirm by placing your initials in the box below that:
- you are able to disclose information about your joint applicant and/or anyone else with whom you say you have a financial link and that you authorise us to make a credit reference search and link or record information about both/all of you
- you understand the implications of this declaration and are you happy to proceed with this application

Further information on how we and credit reference and fraud prevention agencies will use your information in the future will be sent out to you if this application is agreed or are available on request.

INITIALS: