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First name:           Last name:        

Tel/Mobile:           Email Address:  

Company Name:     If applicable

Business Type:                                          

Level of loan required
:                         £  

What is the available security:      
   If Other, please will you describe:   

Will you occupy the property or be a landlord:     

Where in the UK is the security:                               

What is the value of the security:                         £  

What is the value of the loan required:                 £  
what percentage loan to value do you require: 

If the security is mixed use, what % of the property is residential letting:  %  

If the property is to be tenanted, will the property be let from Day 1:             

If the property is an investment, what is the annual gross rental income expected:  

If the property is an Owner Occupier (not investment), what is the EBITDA of your business:  
  EBITDA is earnings before interest, taxes, depreciation and amortisation

What is your main motivation for finance:           

Which statement best describes you:  

Please provide and additional information:             

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