Loan Application Form


Amount of loan £   Term:  months   Purpose of loan: 
Applicant Details
1st Applicant
Title    Forename(s):    Surname:    Marital Status: 

Date of Birth:    Home Tel No:    Mobile No:   
2nd Applicant
Title    Forename(s):    Surname:    Marital Status: 

Date of Birth:    Home Tel No:    Mobile No:   
Address    Post Code: 

Time at Address:  Yrs    Months
Previous Address 1st Applicant    Post Code: 

Time at Previous Address:  Yrs    Months
Previous Address 2nd Applicant    Post Code: 

Time at Previous Address:  Yrs    Months
Employment Details
1st Applicant
Employer's Name    Address:    Post Code: 

Occupation:    Time with employer:  yrs    months   Work Tel No. 

Income £ per month gross
2nd Applicant
Employer's Name    Address:    Post Code: 

Occupation:    Time with employer:  yrs    months   Work Tel No. 

Income £ per month gross
1st Applicant Previous Employer    Previous Occupation:    Time:  yrs 

2nd Applicant Previous Employer    Previous Occupation:    Time:  yrs 
Property Details
Date of Purchase    Purchase Price: £   Current Estimated value: £  

Ex LA:    Type of Property:    No of Bedrooms:   

Amount of Council Discount at Purchase: £

1st Mortgage Lender:    Balance: £   Monthly Payment: £  

Arrears: £

Secured Loan Lender:    Balance: £   Monthly Payment:£   

Arrears: £
If you are an Introducer please enter your details:
Company Name 
Contact Name: 
Contact: 
Email Address: 
Customer Declaration
Disclosure and use of your Information. I/We confirm the information given in this application is accurate and that you, or any lender to whom you submit this application, may use and disclose my data as described in the Borrower Information Guide. I/ We wish to proceed through Blimey Loans and no other brokers. Unless you tick the box below, both we and any other broker or lender we refer this application to may write to you offering other products which we or they feel may be of interest to you. I/We do not wish to receive correspondence from you offering other products which you think may interest me/us.
Security Code: 
Re-enter code: 
Kinnoull House, Riverview Business Park, Friarton Road,Perth, PH2 8DF
Tel: 01738 583008 | Fax: 01738 634560

Licensed by the Office of Fair Trading - Consumer Credit Licence: 611809
Data Protection Act: Z2030159

THINK CAREFULLY BEFORE SECURING OTHER DEBTS AGAINST YOUR HOME
YOUR HOME MAY BE REPOSSESSED IF YOU DO NOT KEEP UP YOUR REPAYMENTS ON A MORTGAGE OR OTHER DEBT SECURED ON IT
NACFB
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