UK Funding Application Form

1

Name

First Name

Last Name

2

Are you over 18 years of age* This field is required.

YESNO

3

Company Name if applicable

4

Your contact details* This field is required.

Please enter your phone

Please enter your email

5

How much would you like to borrow?

£50k - £100k

£100-£300k

£300k +

6

Do you have a property or properties to use as security* This field is required.

YESNO

7

What is the value of your property or properties?* This field is required.

8

How much is the outstanding mortgage if any?* This field is required.

9

Do you have any other outstanding loans/debts against this property?

YESNO

10

Do you have any other outstanding loans/debts against this property?* This field is required.

11

How soon do you require this loan?* This field is required.

Within 2 weeks

Within 1 month

Within 3 months

12

What is the loan required for ?* This field is required.

13

Please confirm the best time to contact you* This field is required.

Morning

Afternoon

Evening

14

Thank you for your enquiry.

We’re sorry, but, we’re unable to assist based on the details provided.