Loan Application FormCompany Form Introducer Details Only complete if referred by an introducer, broker or intermediary. Introducer Name First Name Last Name Introducer Company Name Introducer Company Address Introducer Phone (###) ### #### Introducer Mobile (###) ### #### Introducer Fax (###) ### #### Introducer Email Loan Details Loan Amount * GBP Loan Term * Months Completion Date * MM DD YYYY Description of Loan Requirement * Details of exit strategy / how loan will be repaid * Property Details Property Type * Residential Commerical Mixed Use Other If other, please specify. Current Value * GBP Purchase Date * MM DD YYYY Purchase Price * GBP Tenure Freehold Leasehold If Leasehold, specify years remaining. Ground Rent Per Annum GBP Property Address * Description of Property * Charge Provided on the Property First Charge Second Charge Details of All Current Charges on the Property * If Property Rented/Due to be Rented, Income: GBP If Property Rented / Due to be Rented Lease AST Protected Other If Commercial Lease: Length of Lease Remaining: If Commercial Lease: Details of Any Break Clauses: If Commercial Lease: Full Repairing & Insuring Lease? Full Name & Address of Tenant: Borrower Borrower * Partnership LTD Company LLP Other If other, please specify. Company Name * Company Number * (###) ### #### Country of Incorporation * Registered Trading Address * Name of Company Representative * Mobile Phone * (###) ### #### Office Phone (###) ### #### Email * Disclosure Have you ever? Broken any credit agreements? * Yes No Had a court order for debt registered against you? * Yes No Failed to keep up repayments on a mortgage, credit card of any other financial agreement? * Yes No Lawyer Lawyer: Company * Lawyer: Address * Name of Solictor * Lawyer: Phone * (###) ### #### Lawyer: Email * Accountant Accountant: Company * Accountant: Address * Accountant: Name of Adviser * Accountant: Phone * (###) ### #### Accountant: Email * Thank you! We will get back to you ASAP.
