Mersey Mortgage - In-Principle Unsecured Loan Application

www.mmls.co.uk

To see if your case fits, without any obligation, just complete the following form
- it'll only take a couple of minutes.

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Any field marked * is required!	Personal	Details
	Email address: *
	Title:
	Forename(s): *
	Surname: *
	Date of birth: *
	Marital Status: *
	Number of Dependents: *
	Age of Dependents:

	Address	Details
	Address: *
	Postcode: *
	Time at above address: *	Years Months
	Home Telephone: *
	Mobile Telephone:
	At your present property, are you: *
	if Homeowner:
	Estimated Value:
	Mortgage Outstanding:
	Are payments up to date:
	Name & Address of Landlord or Building Society: *
	Previous Address & Postcode: (if less than 3 years at current address)
	Time at this address:	Years Months
	Do you have any CCJs: *
	if yes:
	how many:
	Do you have any proof of payment:

	Employment	Details
	Name of Employer & Works Address: *
	Works Postcode: *
	Occupation: *
	Time with Employer: *	Years Months
	Work Telephone: *
	Previous Employer, Works Address & Postcode: (If less than 3 years with current employer)
	Previous Employer's Telephone:
	Previous Occupation:
	Time in Previous Employment:

	Income	Details
	Net take home pay: * (weekly or monthly)
	Other Regular Income:	per annum
	Source of other income:

	Monthly	Expenditure
	Mortgage or Rent: *
	Endowment: *
	Council Tax Payments: *
	Insurance: *
	Enter details of other Loans, HP, Credit cards: ie. Company name, Balance, Monthly payments, if you intend to settle & if paid by S/O or D/D. *
	Are the above loans & credit cards up to date:
	if no, give details:

	Credit Card	Details
	Credit card type: *
	Credit card company:
	Exact name on card:
	Credit limit:
	Expiry date:
	How long have you had the card:	Years Months

	Bank	Details
	Account Holder: *
	Name of Bank: *
	Address: *
	Account Opened: *
	Cheque Guarantee Card: *

	Loan	Details
	Purpose of loan: *
	Amount of loan required: *
	Loan term: *
	Payment Protection Required: *

	Other	Details
	Space for your comments:
	How did you find our web site?
	if other:

Please check your entries before submitting this form

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In-Principle Unsecured Loan Application
Mersey Mortgage & Loan Services
Last updated: November 22nd, 2004