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Types of Loan Home Small business Loan Business loan UK Low rate business Secured business		COMPLETING THIS FORM DOES NOT OBLIGATE YOU TO TAKE OUT ANY FINANCE WITH THE COMPANY WE SEND YOUR APPLICATION TO. Required fields marked with * Are you a Homeowner? * Please select from following Yes I am a Homeowner No. i am not a Homeowner Loan Amount Required* (from £5,000 to £100,000) Purpose of Additional Finance * Home Improvements Clear Existing Credit (other e.g. car, holiday, wedding, etc.) Status * ----------------- Married Co-habiting Single Divorced Widowed Separated First Name(s) -1st Applicant* Surname -1st Applicant* D/O/B - 1st Applicant * Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 Email * Confirm Email * Address line 1 * (Used as security) Address line 2 Town/City * County Postcode * Time at address * --- 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 Years   --- 0 1 2 3 4 5 6 7 8 9 10 11 Months Full previous address* Previous Postcode* HomeTelephone No. * Mobile / Work Telephone No. Call Me * ------------------------------ ASAP Anytime Weekday Morning Weekday Afternoon Weekday Evening Weekend Is it a Joint Application? No Yes First Name(s) * Surname * D/O/B * Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 2nd Applicant Employment & Income Details * ---------------------- Employed Self Employed Retired On Benefits Occupation / Job Title Income Before Deductions * ------------------ Every Week Every Month Every Year 1st Applicant Employment & Income Details * ---------------------- Employed Self Employed Retired On Benefits Occupation / Job Title Income Before Deductions * ------------------ Every Week Every Month Every Year Estimated Property Value * Current Mortgage Provider * Estimated Mortgage Balance * Monthly Mortgage Payment * Property Construction * ------------------ Brick Stone Concrete Other Original Purchase Price (estimate if unsure)* DECLARATION AND NOTICE UNDER THE DATA PROTECTION ACT DISCLOSURE AND USE OF YOUR INFORMATION We may as part of the provision of our services to you transfer your personal data between moneysites.com and any of our finance partners or lenders necessary to process your application. Those finance partners or lenders may also transfer your personal data to credit reference agencies in order to carry out the credit checks that are necessary in conjunction with your application. Any transfer of your personal data by them will be done in accordance with their Data Protection Policies. We, and our financial partners, may from time to time send you carefully chosen information about products, services, special offers, promotions and other advertising or marketing materials that we think might interest you. Please indicate if you DO NOT wish to receive such information from us by ticking the box on the left.

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