P
lease complete as many details as
possible
and then click the
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* = Required Data Field
Name:
*
*
Tel:
*
*
Fax:
E-mail Address:
*
*
Evening Tel:
Mobile Tel:
Address:
Postcode:
Age:
Marital Status:
Employment Details:
Please Select an Option
Employed
Self Employed
How Long:
Annual Salary:
Can income be verified:
Please Select an Option
Yes
No
Accountant's Name:
Client 2 Details:
Name:
Daytime Tel:
Evening Tel:
Mobile Tel:
E-Mail Address:
Age:
Marital Status:
Employment Details:
Please Select an Option
Employed
Self Employed
How Long:
Annual Salary:
Can income be verified:
Please Select an Option
Yes
No
Accountant's Name:
Loan Details:
Loan Required:
Purpose of Loan:
Estimated Valuation:
Purchase Price:
Date Purchased:
Current Lender:
Balance Outstanding:
How long with Lender:
Existing 2nd charge or caution:
Any early repayment charges:
Property Details:
Property Type:
Please Select an Option
House
Flat
Maisonette
Bungalow
Freehold / Leasehold:
Please Select an Option
Freehold
Leasehold
If lease how long:
If Flat how many floors:
Is it Above Commercial Premesis:
Please Select an Option
Yes
No
Construction:
Ex Council:
Please Select an Option
No
Yes
Credit History:
Any arrears on 1st in last 12 months:
Please Select an Option
No
Yes
Current Arrears o/s:
Any arrears on 2nd in last 12 months:
Please Select an Option
No
Yes
CCJ’s:
Defaults:
Bankrupt:
Please Select an Option
No
Yes
If yes - When discharged:
IVA:
Additional Notes:
Think carefully before securing other debts against your home. Your home may be repossessed if you do not keep up the repayments on a mortgage or any other debt secured on it.
Daily Express Loans uses a wide panel of lenders, representative of the whole market, to find the secured homeowner loan that suits you best. If you are consolidating other loans or debts, you should be aware that reducing your monthly payments may mean extending the term of the loan and overall amount you repay.
Typical 12.4% APR variable
