Executor Loan Application Form

Executor Loan - Application Form

Please complete the details below to apply for an Executor Loan. If you have any questions, please call us on 0800 009 6590 or email us at probate@amplafinance.com.

Further information is given at https://ampla.finance/executor-loan/

For details on how we use and store customer data, please refer to the Ampla Finance Privacy Policy

Executor Loans are provided by Ampla Consumer Finance Limited.

Please ensure to save your application following each section.

To the best of your knowledge:*

	True	False
The deceased’s Will or Estate is not subject to any dispute or challenge by any third party
The deceased was domiciled and resident in either England, Scotland or Wales at the date of their death
Where applicable, the deceased's Will provides for their Spouse / Partner and any surviving children. If no such individuals exist, please select 'true'.
The applicant is not currently subject to an IVA or Bankruptcy
The applicant is not a politically exposed person or a friend / close associate of anyone politically exposed

Please contact Ampla Finance to discuss your application before proceeding on 0800 009 6590 (selecting option 2)

I am the:*

ExecutorIntroducer

Name*

First NameLast Name

Firm name*

Email*

example@example.com

Contact number*

Is a fee being added to the loan*

YesNo

Fee being added*

Name*

Email*

Contact number*

Date of birth*

Nationality*

Residency*

Current address*

Resided at the above address for more than two years?*

Please provide addresses for all properties resided at over the past 2 years

Employment status*

Occupation

Personal annual income*

Any unspent criminal convictions?*

YesNo

Please provide further details regarding the unspent criminal convictions:

Personal annual expenditure*

Any significant / long-term health conditions or disabilities?*

YesNo

Please provide details of significant / long-term health conditions or disabilities*

Please detail any practical needs to help complete the application

For example: large print, braille or alternative language

Please confirm how many Executors are named on the will*

1 (applicant)234

Please enter details of the second Executor

Please enter details of the third Executor

Please enter details of the fourth Executor

Have any of the Executors passed away or chosen to renounce/have power reserved for them?*

YesNo

We will ask for evidence of this in the upload section.

Please select the purpose of the loan (select all that apply)*

To pay IHT in fullTo pay IHT by instalmentsEstate expensesOther

Is this the first IHT instalment?*

YesNo

Please specify the source of funds used for earlier instalments? If these payments have been covered by assets within the estate, kindly confirm which assets have been used*

Please list and detail all estate expenses*

	Details of costs	Amount (£)
Cost 1
Cost 2
Cost 3
Cost 4
Cost 5
Cost 6

Please detail "Other" purpose*

Total amount to borrow from Ampla Finance?*

We lend from £10,000 upwards

When do you expect to repay the Ampla loan?*

Maximum term of 12 months

What is the repayment vehicle for the loan?*

Name of the deceased*

First NameLast Name

Date of death*

Did the deceased have a valid will on the date of death?*

YesNo

Has a will search been complete?*

YesNo

Please note, if the application is approved we can complete a will search on your behalf, however, it can take between 30-60 days to complete.

Please confirm the date of the will?

Has Grant of Probate/Confirmation been applied for?*

YesNo

Has Probate/Confirmation been granted?*

YesNo

Please enter date Probate was granted *

Date

When was Grant of Probate/Confirmation applied for?*

Date

Please enter date Grant of Probate/Confirmation is likely to be granted *

Date

Has letters of administration been applied for?*

YesNo

Has letters of administration been granted?*

YesNo

Approx. when is the Grant expected to be issued?*

Date

Please list all beneficiaries (please note all beneficiaries will need to consent to the loan):

	Name	Country Resided	Contact Number	Email
Beneficiary 1
Beneficiary 2
Beneficiary 3
Beneficiary 4
Beneficiary 5
Beneficiary 6
Beneficiary 7
Beneficiary 8
Beneficiary 9
Beneficiary 10

If a professional firm is instructed to administer the estate, please enter their details below:

The Professional Firm has been instructed to manage (select all that apply)

Estimated fees

Are any other Professional Firms involved

YesNo

Please enter details of the second 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 third professional firm

The Professional Firm has been instructed to manage (select all that apply)

Copy of the deceased’s Death Certificate*

For estates with a will - A copy of the Will, along with any codicils or letters of wishes *

A copy of IHT Forms (England) or C1 & C2 (Scotland) and any supporting schedules

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

Instruction letter from conveyancing firm (if applicable)

Asset/investment valuation statements

By signing this form, I confirm that as Executor of the above estate:*

The information provided on this application form is correct to the best of my knowledge;I am authorised by all the Executors named above to submit this application on their behalf;All the Executors named above have been provided with a copy of the Ampla Finance Privacy Policy;All the Executors named above provide their consent for Ampla Operations Limited to perform third party checks as detailed in Section 5 of the Ampla Finance Privacy Policy;All the Executors named above give their authorisation for Ampla Operations Limited to share their information with the other Executor(s) and the Professional Firm(s) managing the Deceased’s estate; andAll the Executors named above give their authorisation for the Professional Firm(s) to provide information relating to the estate to Ampla Operations Limited.

By signing this form, I confirm that as the Introducer of the above named client(s):*

The information provided on this application form is correct to the best of my knowledge;I am authorised by all the Executors named above to submit this application on their behalf;All the Executors named above have been provided with a copy of the Ampla Finance Privacy Policy;All the Executors named above provide their consent for Ampla Operations Limited to perform third party checks as detailed in Section 5 of the Ampla Finance Privacy Policy;All the Executors named above give their authorisation for Ampla Operations Limited to share their information with the other Executor(s) and the Professional Firm(s) managing the Deceased’s estate; andAll the Executor(s) named above give their authorisation for the Professional Firm(s) to provide information relating to the estate to Ampla Operations Limited.

Signature*

Print Name*

Date*

Introducing Firm Contact Details:

Executor Details:

Details of the loan required

Details of the Estate

Beneficiary Details

Professional Firm Details

Application documentation