Secured Loan Application Form by jolinmilioncherie

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									V1-31/1/12




                                                                                                                                                       Helping Fund UK Business


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Secured Loan Application Form
   1         Sub Broker Details                                                             2      Master Broker Details
    Company name                                                                        Company name
                                                                                           Brightstar Financial
    Contact name                                                                        Contact name


    Email                                                                               Email
                                                                                           secured@brightstarfinancial.net
    Telephone                                CCL no.                                    Telephone                                CCL no.
                                                                                          01277 725166                                641220


   3         New Loan Details
    Loan amount required (£)                 Loan purpose                                                                        Loan term




   4         Applicant Details
    First applicant                                                                     Second applicant
    Title            Forename                                                           Title             Forename


    Middle name(s)                                                                      Middle name(s)


    Surname                                                                             Surname


    Maiden name                                                Date of birth            Maiden name                                                 Date of birth


    Number of dependents/ages                Marital status                             Number of dependents/ages                Marital status


    Home telephone number                                                               Home telephone number


    Mobile telephone number                                                             Mobile telephone number


    Occupation                                                                          Occupation


    Employed/Self-Employed                                                              Employed/Self-Employed


    Company name                                                                        Company name


    Company address                                                                     Company address


                                                  Post code                                                                             Post code
    Company telephone number                                                            Company telephone number


    Annual income                                      Period of employment (yrs)       Annual income                                      Period of employment (yrs)




    Brightstar Financial Limited. Jubilee House, The Drive, Warley Hill Business Park, Brentwood, Essex, CM13 3FR.
    Registered in England and Wales Company no: 07462342. Tel: 01277 725166. Fax: 01277 725378. Email: info@brightstarfinancial.net

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   4       Applicant Details (cont)
    First applicant                                                                             Second applicant
    Other income                                 Income type                                    Other income                                 Income type


    If self-employed last 3 years net profit                                                    If self-employed last 3 years net profit
     £                           £                            £                                  £                            £                            £
    National insurance number                                                                   National insurance number



   5       Address Details
    Current address                                                                             Property type (flat / house etc)             If flat, how many floors?


                                                                                                No. of bedrooms
                                                      Post code
    Previous address (if less than 3 years at current)
                                                                                                Estimated current value (£)                  Purchase price (£)

                                                      Post code
                                                                                                Date of purchase
    Address of security (if different from current)

                                                                                                Ex-local authority?                                      Yes                    No
                                                      Post code
                                                                                                                                                          a
                                                                                                                                                         aa                      a
                                                                                                                                                                                aa
    Construction type (bricks & mortar etc)                                                     If yes, did you purchase as a sitting tenant?            Yes                    No

                                                                                                                                                          a
                                                                                                                                                         aa                      a
                                                                                                                                                                                aa
   6       Existing Mortgage Details
    Mortgage balance (£)                                                                        Is this a flexible mortgage?                             Yes                    No

                                                                                                                                                          a
                                                                                                                                                         aa                      a
                                                                                                                                                                                aa
    Mortgage lender                                                                             Are there any other loans secured against the            Yes                    No
                                                                                                property?
                                                                                                                                                          a
                                                                                                                                                         aa                      a
                                                                                                                                                                                aa
    Mortgage account number                                                                     Have you made the last 3 mortgage payments Yes                                  No
                                                                                                on time?
                                                                                                                                                          a
                                                                                                                                                         aa                      a
                                                                                                                                                                                aa
    Monthly payment (£)                                                                         Any missed mortgage payments in the last 36              Yes                    No
                                                                                                months?
                                                                                                                                                          a
                                                                                                                                                         aa                      a
                                                                                                                                                                                aa
   7       Signatures & Declarations
    By signing this form, you declare that:
    •	 I/we confirm the information given is accurate and that you, or any lender to whom you submit this application, may use and disclose my data as described.
    •	 I/we understand that the broker may be paid a commission by the lender of the work undertaken in preparing my/our loan application. This is in addition to any fee that may
       be charged.
    •	 I/we confirm that Payment Protection Insurance has not been offered with this loan and that I/we have been advised to seek alternative cover elsewhere if wanted, or to
       obtain independent financial advice.
    •	 Brightstar Financial Limited, or the introducer, may search files or credit reference agencies which will keep a record of the search. I acknowledge that multiple credit searches
       may affect my ability to obtain credit elsewhere. Details of how I conduct the account (including any reppossession of the property and any arrears) may be disclosed to
       these agencies. This information may be used by other lenders in assessing applications from me and members of my household and for the occasional debt tracing and
       fraud prevention.
    To mortgage provider, please accept this as my/our written authority to release such information as required by the enquirer.
    Mortgage account number


    First applicant                                                                             Second applicant
    Signature                                                                                   Signature




    Print Name                                                                                  Print Name


    Date                                                                                        Date



    Brightstar Financial Limited. Jubilee House, The Drive, Warley Hill Business Park, Brentwood, Essex, CM13 3FR.
    Registered in England and Wales Company no: 07462342. Tel: 01277 725166. Fax: 01277 725378. Email: info@brightstarfinancial.net

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