Secured Loans Application

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First applicant details:
Loan Purpose:	-Please Select- Home Improvement Debt Consolidation Holiday Car/Bike Loan Cosmetic Surgery Wedding Remortgage Business Loan Commercial Finance Bridging Finance Other
Your title	Mr Mrs Miss Ms
Your first name
Your surname
Date of birth	Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Month January February March April May June July August September October November December   Year 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907
House name / flat number	If you live in a flat please enter flat name or number here, e.g. Flat 12, top-floor flat
House number
Post code
Daytime telephone
Evening telephone
Mobile telephone	(optional)
Email address
Marital status	Please select from this list Married Single Divorced Separated Widowed Co-habiting Other
Employment status	Please select from this list Employed Self-employed Professional self-employed Unemployed Housewife/househusband Student Retired
Your total income	Please select £1,000 £2,000 £3,000 £4,000 £5,000 £6,000 £7,000 £8,000 £9,000 £10,000 £11,000 £12,000 £13,000 £14,000 £15,000 £16,000 £17,000 £17,500 £18,000 £19,000 £20,000 £21,000 £22,000 £23,000 £24,000 £25,000 £26,000 £27,000 £28,000 £29,000 £30,000 £31,000 £32,000 £33,000 £34,000 £35,000 £36,000 £37,000 £38,000 £39,000 £40,000 £41,000 £42,000 £43,000 £44,000 £45,000 £46,000 £47,000 £48,000 £49,000 £50,000 £51,000 £52,000 £53,000 £54,000 £55,000 £56,000 £57,000 £58,000 £59,000 £60,000 £61,000 £62,000 £63,000 £64,000 £65,000 £66,000 £67,000 £68,000 £69,000 £70,000 £71,000 £72,000 £73,000 £74,000 £75,000 £76,000 £77,000 £78,000 £79,000 £80,000 £81,000 £82,000 £83,000 £84,000 £85,000 £86,000 £87,000 £88,000 £89,000 £90,000 £91,000 £92,000 £93,000 £94,000 £95,000 £96,000 £97,000 £98,000 £99,000 £100,000
Partner details: Title Mr Mrs Miss Ms First name Surname Date of birth Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Month January February March April May June July August September October November December   Year 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 Employment status Please select from this list Employed Self-employed Professional self-employed Unemployed Housewife/househusband Student Retired Total income Please select £0 £1,000 £2,000 £3,000 £4,000 £5,000 £6,000 £7,000 £8,000 £9,000 £10,000 £11,000 £12,000 £13,000 £14,000 £15,000 £16,000 £17,000 £18,000 £19,000 £20,000 £21,000 £22,000 £23,000 £24,000 £25,000 £26,000 £27,000 £28,000 £29,000 £30,000 £31,000 £32,000 £33,000 £34,000 £35,000 £36,000 £37,000 £38,000 £39,000 £40,000 £41,000 £42,000 £43,000 £44,000 £45,000 £46,000 £47,000 £48,000 £49,000 £50,000 £51,000 £52,000 £53,000 £54,000 £55,000 £56,000 £57,000 £58,000 £59,000 £60,000 £61,000 £62,000 £63,000 £64,000 £65,000 £66,000 £67,000 £68,000 £69,000 £70,000 £71,000 £72,000 £73,000 £74,000 £75,000 £76,000 £77,000 £78,000 £79,000 £80,000 £81,000 £82,000 £83,000 £84,000 £85,000 £86,000 £87,000 £88,000 £89,000 £90,000 £91,000 £92,000 £93,000 £94,000 £95,000 £96,000 £97,000 £98,000 £99,000 £100,000
Other details:
Do you own your property?	Yes, with mortgage Yes, outright No, Living with parents No, I'm a tenant
Have you missed more than 1 mortgage payment within the last 10 months?	No Yes Not applicable
Property value:	Please select from this list £50,000 £60,000 £70,000 £80,000 £90,000 £100,000 £110,000 £120,000 £130,000 £140,000 £150,000 £160,000 £170,000 £180,000 £190,000 £200,000 £210,000 £220,000 £230,000 £240,000 £250,000 £260,000 £270,000 £280,000 £290,000 £300,000 £310,000 £320,000 £330,000 £340,000 £350,000 £360,000 £370,000 £380,000 £390,000 £400,000 £410,000 £420,000 £430,000 £440,000 £450,000 £460,000 £470,000 £480,000 £490,000 £500,000 £510,000 £520,000 £530,000 £540,000 £550,000 £560,000 £570,000 £580,000 £590,000 £600,000 £610,000 £620,000 £630,000 £640,000 £650,000 £660,000 £670,000 £680,000 £690,000 £700,000 £710,000 £720,000 £730,000 £740,000 £750,000 £760,000 £770,000 £780,000 £790,000 £800,000 £810,000 £820,000 £830,000 £840,000 £850,000 £860,000 £870,000 £880,000 £890,000 £900,000 £910,000 £920,000 £930,000 £940,000 £950,000 £960,000 £970,000 £980,000 £990,000 £1,000,000
Mortgage balance:	Please select from this list £1,500 <£2,000 £2,500 £3,000 £3,500 £4,000 £4,500 £5,000 £6,000 £7,000 £7,500 £8,000 £9,000 £10,000 £11,000 £12,000 £13,000 £14,000 £15,000 £16,000 £17,000 £18,000 £19,000 £20,000 £25,000 £30,000 £35,000 £40,000 £45,000 £50,000 £55,000 £50,000 £60,000 £70,000 £80,000 £90,000 £100,000 £110,000 £120,000 £130,000 £140,000 £150,000 £160,000 £170,000 £180,000 £190,000 £200,000 £210,000 £220,000 £230,000 £240,000 £250,000 £260,000 £270,000 £280,000 £290,000 £300,000 £310,000 £320,000 £330,000 £340,000 £350,000 £360,000 £370,000 £380,000 £390,000 £400,000 £410,000 £420,000 £430,000 £440,000 £450,000 £460,000 £470,000 £480,000 £490,000 £500,000 £510,000 £520,000 £530,000 £540,000 £550,000 £560,000 £570,000 £580,000 £590,000 £600,000 £610,000 £620,000 £630,000 £640,000 £650,000 £660,000 £670,000 £680,000 £690,000 £700,000 £710,000 £720,000 £730,000 £740,000 £750,000 £760,000 £770,000 £780,000 £790,000 £800,000 £810,000 £820,000 £830,000 £840,000 £850,000 £860,000 £870,000 £880,000 £890,000 £900,000 £910,000 £920,000 £930,000 £940,000 £950,000 £960,000 £970,000 £980,000 £990,000 £1,000,000
Loan amount:	£1,000 £1,500 <£2,000 £2,500 £3,000 £3,500 £4,000 £4,500 £5,000 £6,000 £7,000 £7,500 £8,000 £9,000 £10,000 £11,000 £12,000 £13,000 £14,000 £15,000 £16,000 £17,000 £18,000 £19,000 £20,000 £25,000 £30,000 £35,000 £40,000 £45,000 £50,000 £55,000 £60,000 £65,000 £70,000 £80,000 £90,000 £100,000 £105,000 £110,000 £115,000 £120,000 £125,000 £130,000 £130,000+
Best time to contact:	Select from this list Morning Afternoon Evening

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