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SECURED LOAN APPLICATION

* = mandatory fields

Loan details*

Loan amount

Term Years
Purpose of loan*

Please tick plans

Payment Protection Plan  Single Life, Single Incident Sickness & Involuntary Unemployment  Joint Life, Single Accident Sickness & Involuntary Unemployment 

PERSONAL DETAILS

  First Applicant Second Applicant
Title
Surname*
Forename*
Previous Surname
Date of Birth (dd/mm/yyyy)*
Marital Status*
Dependents No Ages No Ages
Home Telephone No*
Mobile Telephone No
Current Address*
Time at Present Address* Years Months Years Months
Previous address
time at previous address Years Months Years Months

EMPLOYMENT & INCOME DETAILS

Current Employers Name & Address OR
your Business name and address (if self employed) *
Telephone no
Occupation
Time with current employer Years Months Years Months
Previous employer (if less than 3 years with current employer)
Time with previous employer Years Months Years Months
 
Accountants name and number (for Self Employed only)
Main income (Gross/Monthly)*
Other Income (Gross/Monthly)*
Is self-cert required?* YES NO YES NO
Bank Details* Name Time with bank (month/years) Name Time with bank (month/years)
Acc no Sort-code Acc no Sort-code

 

Expenditure Lender Acc no Balance Payment Arrears To be consolidated
First Mortgage YES NO YES NO
second mortgage YES NO YES NO
Bank Loan YES NO YES NO
Car Loan YES NO YES NO
Credit Card YES NO YES NO
Other YES NO YES NO

 

Type of Property* Terraced Semi Detached Flat Other
Is the property jointly owned?* YES NO
Is the property* Freehold  Leasehold
year property built
is any part of property let* YES NO Construction of property
Number of rooms Bedrooms Bathrooms
  Reception Rooms Garage
Date of purchase (dd/mm/yyyy)*
purchase price*
present value (estimated)*
is the property ex-council* YES NO
Name and address of mortgage lender
account number
are payments insured YES NO
date current mortgage started (dd/mm/yyyy)*
details of previous mortgage (if current mortgage held for less than 12 months)
Name and address of secured loan/overdraft lender
Account Number

 

Did you have any CCJ's or defaults?* YES NO: If YES please provide full details below
Additional information (to include full details of any adverse)


 
Additional information (to include previous addresses, employment etc)

I/we authorise Crystal Finance to conduct a credit search to find a suitable secured loan for circumstances based on the answers I have given on this application and I/We have also read the DPA statement and agree to your terms set in the statement.

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