Loan Application FormIndivdiual 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 * Sole Trader Partnership LTD Company LLP Trust Other If other, please specify. Applicant 1 Applicant 1: Title * Mr Mrs Miss Other Applicant 1: First Name * Applicant 1: Middle Name(s) Applicant 1: Surname * Applicant 1: Previous Name(s) If applicable Applicant 1: Date of Birth * MM DD YYYY Applicant 1: Nationality * Applicant 1: Mobile Phone * (###) ### #### Applicant 1: Home Phone (###) ### #### Applicant 1: Work Phone (###) ### #### Applicant 1: Email * Applicant 1: Main Residential Address * Applicant 1: Time at Address * Applicant 1: Previous Address(es) If less than 3 years at current address Applicant 1: Time at Address Applicant 1: Company Name * Applicant 1: Employment Status * Employed Self Employed (please provide accounts below) Sole Trader Director Other Applicant 1: Company Address * Applicant 1: Time in Employment * Applicant 1: Net Income * GBP Applicant 1: Any Further Employment Details Applicant 2 Applicant 2: Title If applicable Mr Mrs Miss Other Applicant 2: First Name If applicable Applicant 2: Middle Name(s) Applicant 2: Surname If applicable Applicant 2: Previous Name(s) If applicable Applicant 2: Date of Birth If applicable MM DD YYYY Applicant 2: National Insurance Number If applicable Applicant 2: Mobile Phone If applicable (###) ### #### Applicant 2: Home Phone If applicable (###) ### #### Applicant 2: Work Phone If applicable (###) ### #### Applicant 2: Email If applicable Applicant 2: Main Residential Address If applicable Applicant 2: Time at Address If applicable Applicant 2: Previous Address(es) If less than 3 years at current address Applicant 2: Time at Address Disclosure Have you ever? Broken any credit arrangements? * Yes No Had a court order for debt registered against you? * Yes No Failed to keep up repayments on a mortgage, credit card or any other financial arrangement? * 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.
