About the loan

1. 1. Loan amount
   2. Period: Select... 0-3 months 1 years2 years3 years4 years5 years6 years7 years8 years9 years10 years11 years12 years13 years14 years15 years16 years17 years18 years19 years20 years21 years22 years23 years24 years25 years 25+ years
2. Purpose: Please Select... Car Finance Debt Consolidation Holiday Home Improvement Wedding Pay Day/Short Term Loan Other
3. Employment status: Please Select... Employed Self-employed Homemaker Unemployed Retired Other
4. Are you a homeowner? Yes No

1. Property Value:
   This will help us to direct you to the correct adviser, ensuring you achieve the best interest rates for your circumstance depending on the level of equity (difference between property value and outstanding mortgage) in your property
2. Mortgage outstanding:
   This will help us to direct you to the correct adviser, ensuring you achieve the best interest rates for your circumstance depending on the level of equity (difference between property value and outstanding mortgage) in your property

About you

1. Title / First Name   Mr Mrs Miss Ms
2. Surname
3. Address (Line 1)
4. Postcode
5. Email Address
6. 1. Telephone
   2. Work/Mobile Phone
7. Date of Birth 12345678910111213141516171819202122232425262728293031   Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920191919181917191619151914
8. Credit Rating: Good Fair Poor
9. Within 12 months, have you (or 2nd applicant) missed loan/mortgage
   repayments, declared bankruptcy or had a CCJ or IVA? If yes - we can still help. Yes No
   • An IVA is an Individual Voluntary Arrangement, this is an arrangement that allows someone who is unable to pay their debts to continue in business so they can pay off the debts without being made bankrupt.
   • A CCJ is a County Court Judgement, this could be issued against you if you owe someone money and have been unable to pay.