Loan Application Form

Please use this form to begin formal enquiries

Date of application
Day:  Month:  Year:
Name & address of borrower/applicant
Firstname:
Surname:
Private address:
Telephone:
Mobile:
Email:
Fax:
Name and address of borrower/applicant's solicitor
Name of firm:
Contact:
Address:
Telephone:
Mobile:
Email:
Fax:
Name and address of company/SPV borrower
Company name:
Registered office address:
Co Reg. No.:
Director (1):
Director (2):
Name and address of applicant/co-directors (if different to above)
1:
2:
3:
5. Secured property (inc. postcode):
Address:
Value:
6. Additional property(ies) offered as security for loan:
(1) Address:
Value:
(2) Address:
Value:
7. Amount of loan required:
Amount of loan required:
Loan to value:
Term of loan (3 or 6 months):
8. Broker/introducer:
Name of firm:
Contact name:
Address:
Telephone:
Mobile:
Email:
Fax:
9. Broker agreed fee with applicant:
Agreed:
Fee agreed (sum or %):
10. Purpose of loan:
Purchase
Property Development
Property Improvement
Equity Release
Replacing existing bridging loan / borrowings
Other (please specify):
11. Repayment proposals:
Details of status of exit:
12. Details of existing first charges:
Specify which of the above properties this refers to:
Name of lender:
Lender's address:
Amount of loan outstanding:
Loan ref. no.:
13. Adverse credit details:
Do you have any CCJ's?:
Details (no., amounts and explanation)
1:
2:
3:
Have you ever been bankrupt or entered into an IVA?:
Details (date of discharge and brief explanation for bankruptcy or IVA)
Warning: I/we declare and confirm that the information contained herein and supplied by me/us is true, accurate and complete, and can be used to form the basis of any contract between me/us and Lextel Services To Industry Limited, trading as Fast Bridging and Finance. I/we agree and confirm that our Lenders may make such enquiries, obtain references and confirmations, as may be deemed appropriate. I/we also agree that any information obtained and held about me/us may be retained on computer and disclosed to other persons for the purposes required by Lextel Services To Industry Limited, trading as Fast Bridging and Finance and our Lenders. By submitting this form electronically, I/we (the Applicant) confirm that Lextel Services To Industry Limited, trading as Fast Bridging and Finance and Lenders can accept this form as being signed and authorised by me/us.
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