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  Loan required (Secured Loan)    
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  Loan required   £    
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  1st Applicants details    
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  Title      
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  Full name    
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  Date of birth   / / DD/MM/YYYY  
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  2nd Applicants details    
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  Title      
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  Full name    
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  Date of birth   / / DD/MM/YYYY  
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  Address of property offered as security    
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  Address    
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  Postcode    
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  Other address(es) resided at in the last 3 years

(please also state which applicant resides there) 		   
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  Telephone    
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  Mobile    
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  Fax    
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  Email    
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  Financial details    
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  Gross annual salary  
Applicant 1 Applicant 2
£ £
   
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  Employment status  
Applicant 1 Applicant 2
Employed Employed
Self employed Self employed
Self cert. req? Self cert. req?
 
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  Property details    
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  Date property purchased   / / DD/MM/YYYY  
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  Main residence  
Yes No
 
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  Purchase price   £  
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  Current value   £  
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  Mortgage details    
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  Which lender is current mortgage with?      
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  Monthly payments   £  
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  Outstanding balance
  £  
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  Do applicants have a current secured loan or second mortgage  
Yes No
If yes amount owed   £ 		 
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  Other outgoings
  £ (Endowment etc.)  
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