Inheritance Loan Application Form

Inheritance Loan - Application Form

Please complete the details below to apply for an Inheritance Loan.

We recommend you save your application throughout, should you need to return to complete at a later date. You can do this by selecting the Save button, at the bottom of each page.

If you have any questions, please call us on 0800 009 6590 or email us at legacy@amplafinance.com.

Inheritance Loans are provided by Ampla Consumer Finance.
Your Details
Name*
Email*
Contact number*
Date of birth*
Nationality*
Residency*
Current address*
Have you lived at the above address for more than two years?*
Please provide addresses for all properties you have resided at over the past 2 years
Employment status*
Occupation
Employer
Years with employer
Personal annual income*
Personal annual expenditure*
Do you have any unspent criminal convictions?*

I have unspent criminal convictionsI do not have unspent criminal convictionsOther
Please provide further detail regarding your unspent criminal convictions:
Do you have any significant / long-term health conditions or disabilities?*

YesNo
Please provide details of significant / long-term health conditions or disabilities*
Do you have any practical needs to help complete your application
For example: large print, braille or alternative language

Details of your inheritance and the loan you require
What is the estimate value of proceeds you expect to receive and the assets this is likely to be paid from?*
Is there a property to sell as part of the inheritance?*

YesNo
Please list any building improvements that need to be made before a sale can go ahead?
Has a conveyancing firm been instructed?
What stage is the sale at?
How much would you like to borrow from Ampla Finance?*
When do you wish to receive the funds from Ampla Finance?*
When do you expect to receive your inheritance and repay the Ampla loan?*
Maximum term of 24 months
When expect to repay the loan?*
Please describe the purpose of the loan*

Beneficiaries and Executor Details
How many other Beneficiaries are named on the will?*

None1234
Please enter details of the second Beneficiary
Please enter details of the third Beneficiary
Please enter details of the fourth Beneficiary
Please enter details of the fifth Beneficiary
How many Executors are there?*

123+
Please enter details of the Executor
Please enter details of the second Executor
Please enter details of the third Executor

Professional Firm Details
Please enter details of the Professional Firm instructed
The Professional Firm has been instructed to manage (select all that apply)
Are any other Professional Firms involved*

YesNo
Please enter details of the professional firm
The Professional Firm has been instructed to manage (select all that apply)
Are any other Professional Firms involved*

YesNo
Please enter details of the professional firm
The Professional Firm has been instructed to manage (select all that apply)

Application documentation
Are you currently seeking or involved in any IVA, Trust Deed, Bankruptcy, Debt Management Plan or Debt Relief order?

NoYes
Please provide details?
Please provide your bank details for payment of the loan
Copy of the deceased’s Death Certificate

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Certified copy of the Will for estates with a Will

Cancelof
Certified copy of the Grant of Probate (for estates with a Will), or Grant of Letters of Administration (for intestate estates)

Cancelof
Certified copy of IHT Forms and any supporting schedules

Cancelof
Instruction letter(s) from professional firm(s) appointed to settle the estate

Cancelof
Any additional information on the assets and liabilities in the estate

Cancelof
By signing this form, you hereby confirm that:*

I have been provided with a copy of the Ampla Finance Privacy Declaration, andThe information provided on this application form is correct to the best of my knowledge, andI provide my consent for Ampla Operations Limited to perform third party checks including credit checks, andI confirm that I give my explicit consent for Ampla to record and store any special category data that is confirmed during the application process.I confirm my authorisation for Ampla Finance to share my information with the Executor(s) and the Professional Firm(s)s (if applicable) managing the Deceased’s estate, and for the Executor(s) and Professional Firm(s) (if applicable) to provide information relating to the estate and my interest in it, to Ampla Finance.
Signature*

Clear
Print Name*
Date*

MonthDayYear
Should be Empty:

Your Details

Details of your inheritance and the loan you require

Details of the Deceased and their Will

Beneficiaries and Executor Details

Professional Firm Details

Application documentation