Loan Assured Mortgages

Loan Application Form

Please provide as much information as possible in your loan application below.
Our team of mortgage advisers and underwriters will be in contact with you as soon as possible.
(Usually within one hour during normal working hours).
Please feel free to to ring us on 0845 0777 007 (weekdays from 9.00 AM-7.00 PM and
from 09.00 AM- 03.00 PM on Saturdays) for an update on how your application is proceeding.
*required fields

Applicant(s)

	Main Applicant	Second Applicant
Title
First Name*
Last Name*
DOB*
Email*
Day time telephone*
Mobile
Evening telephone

3 Year Address History

Current address
	Main Applicant	Second Applicant
Address Line 1
Address Line 2
City
Postcode
Previous address (If applicable)
	Main Applicant	Second Applicant
Address Line 1
Address Line 2
City
Postcode

Employment status

	Main Applicant	Second Applicant
Type of employment
Employer / Company Name
Occupation / Position
Start Date
Basic Salary / Net Profit (£)
Additional income (£)
Can you prove this income?

Loan required?


Loan Amount Required (£)
Term
Type of Loan

What type of loan do you require?

Mortgage Secured Loan

Customer Declaration
We will use your information for the purposes of selecting the most suitable mortgage lender and, if granted, administering the mortgage. We may pass your information on to lending institutions and companies
within the Loan Assured Group, for such purposes.

The Loan Assured Group comprises Loan Assured Mortgages Ltd, The Underwriting Department Ltd and Assured Marketing Ltd.

To help any prospective Lender make credit decisions about you, to prevent fraud, to check your identity and to prevent money laundering we will search your records at credit reference agencies at commencement and may do so periodically thereafter. Details of our search and your application will be added to your records whether or not this application proceeds and will be seen by other organisations carrying out later searches.

By submitting this form you agree for your information to be used in this way.