The Mortgage Gallery Secured Loan

Please fully complete the below enquiry form, once submitted a member of our loan team will contact you within the next 24 hours with a personal quotation. Field's marked with a * are required
Part 1; About the Loan
Loan Amount * £ . Pounds Pence
Term - Years *
Purpose of Loan Home improvements / Home furnishings Consolidation Wedding Car Other - Please explain below
Other / Comments

Please note business purposes's is not an acceptable purpose
Part 2; Your Details
Title *
Name * First Last
Date of Birth * / DD / MM YYYY
Marital Status *
Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Client Telephone Number 1 *
Client Telephone Number 2
Time at Address *

If less than 3 years please complete the previous address details below.
Previous Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

If less than 3 years please complete the previous address.
Part 3; Second Applicants details (If your are married the lenders will require a joint application)
Title
Name First Last
Date of Birth / MM / DD YYYY
Marital Status
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Time at Address

If less than 3 years please, complete the previous address details below.
Previous Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Part 4; Employment Details
Employers Name / Company Name *
Employers Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Occupation *
Time Employed *
Gross Pay Per Annum * £ . Pounds Pence
If income is made up from more than one source or the client has benefits as part of the declared income please give an explanation below
Income explanation
Self Employed *

If self employed please provided the accountants details below
Part 4.1; Applicant 2 Employment Information (If Applicable)
Employers Name / Company Name
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Occupation
Time Employed
Gross Pay Per Annum £ . Pounds Pence
If income is made up from more than one source or the client has benefits as part of the declared income please give an explanation below
Income explanation
Self Employed

If self employed please provide the accountants details below
Part 5; Property Details
Property Value * £ . Pounds Pence
Mortgage Balance * £ . Pounds Pence
Mortgage Lender *
Monthly Mortgage Payment * £ . Pounds Pence
Current Mortgage Status *
Remaining Mortgage Term - Years *
Purchase Date * / MM / DD YYYY
Purchase Price * £ . Pounds Pence
Ex Council Property *
Buy to Let / None owner occupied *

If the security Address is buy to let please provide the address below
Buy to Let - Address if applicable
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

If the security Address is buy to let please provide the address here.
Part 6; Credit history
Defaults *
CCJ's *
Arrears *
Been declined a loan within the last 3 months? *
Important information

I/We agree that you or any lender to whom you submit this application, may use and disclose my data as described in the pages entitled "Data Protection" and that these pages have been read and understood
*
By submitting this form you are giving us permission to carry out a credit search.
Digital Signature First Last
Please imput your full name, to confirm the above authorisation
For more information you can email us

The Mortgage Gallery Secured Loan

Please fully complete the below enquiry form, once submitted a member of our loan team will contact you within the next 24 hours with a personal quotation. Field's marked with a * are required

Part 1; About the Loan

Part 2; Your Details

Part 3; Second Applicants details (If your are married the lenders will require a joint application)

Part 4; Employment Details

Part 4.1; Applicant 2 Employment Information (If Applicable)

Part 5; Property Details

Part 6; Credit history

Important information