Secured Loan Form

Use this form to submit new Secured Loan cases. Your case will then be progressed by one of our Secured Loan Underwriters.

* Indicates required fields

Introducer Details

Details for Client 1 (Principle Contact)

Please enter here the client's residential address.

Is this the client's main address?: Yes No Unknown

day month year

Income Details

(In years and months)

Requirement

(If not required, please enter 0)

Unless you are FSA authorised and regulated to give insurance advice you will be unable to advise or recommend any insurance products. You may ask the customer if they would like us to provide more information on the cover available by selecting from the box below in answer to this question:

Mortgage Details

Years Months If an exact number of years, enter 0 in months

Years Months If an exact number of years, enter 0 in months

(Please enter a whole number)

Details of Property against which the Loan is to be Secured

Is the property ex-council?
If Yes, what was the discount amount (£)?
If Yes, when was it bought (year)?

How many floors in the block?
How many units in the block?
What floor is it on?
What is the length of lease remaining?

Details of Security Property