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All business transacted is subject to our terms of business, by submitting an application you agree to be bound by the terms of business.

Broker Details - QUESTIONS MARKED * MUST BE ANSWERED

*Name

*Company

*Address

*email

*phone

*Do you have authorisation from your network to use TFC Secured?

Please select from the options below: Yes I have authorisation form my network No I am directly authorised

*How would you like us to proceed with this enquiry?

Please select from the options below: Email a quote to me - DO NOT issue documents Email a quote to me & ISSUE documents now Other - Please write comments in notes at end of form

*Please indicate which of the following options you would like to be quoted for:

Please select from the options below: Standard terms - variable rate capital and interest Fixed interest - capital and interest repayments Interest only - variable rate interest only

Residential Status Of Applicant - QUESTIONS MARKED * MUST BE ANSWERED

*Your current resident status

select Homeowner Mortgage Payer Property/Land Owner Tenant Living with Parents

*Amount of loan required

*Repayment term required

select 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 11 Years 12 Years 13 Years 14 Years 15 Years 16 Years 17 Years 18 Years 19 Years 20 Years 21 Years 22 Years 23 Years 24 Years 25 Years

*Purpose of loan

Applicant Details - QUESTIONS MARKED * MUST BE ANSWERED

*Full Name

Maiden Name (if applicable)

*Date of Birth (in the following format 23/04/1975)

*Employment Status

select Employed Self Employed with accounts Self Employed no accounts Retired/private pensions Retired/state pensions Other - please state

If other please specify

*Time with current employer

Average Gross Weekly income

Postcode

Full Address

Previous postcode - if you have been at your current address for less than 3 years.

Previous Address in full:

Daytime telephone number

Evening telephone number

*Email address (IF NONE STATE "NONE")

How long have you held your present bank account?

Have you had any court orders, defaults or debts registered?

select Yes No

If yes, please give brief details

Partner or Joint Applicant Details - QUESTIONS MARKED * MUST BE ANSWERED

*Full Name - IF NONE STATE "NONE" IN THE BOX (APPLICATION MUST BE IN JOINT NAMES IF YOU ARE MARRIED OR THE PROPERTY IS JOINTLY OWNED)

Maiden Name (if applicable)

Date of Birth

Employment Status

select Employed Self Employed with accounts Self Employed no accounts Retired/private pensions Retired/state pensions Other - please state

If other, please specify

Time with current employer

Average gross weekly income

Have you had any court orders, defaults or debts registered?

select Yes No

If yes, please give details

Property Details - QUESTIONS MARKED * MUST BE ANSWERED

Address of property to be used as security (if different from home address)

*Type of property

select Semi Detached Detached Terraced Flat/maisonette Flat High Rise (5+ Floors) Shop & Flat Business Premises Land Other (please State)

If other please specify

*Approximate value of the property now

*Date you purchased the property

*Price you paid for the property

Is the property ex-council?

select Yes No

If yes, how much discount was given?

Who lives in the property?

select Applicant Tenant Vacant Relative Students

Is the property tenanted?

select Yes No

If yes, state monthly rent received.

Current Mortgage Details - QUESTIONS MARKED * MUST BE ANSWERED

IF YOU DO NOT HAVE A MORTGAGE - PLEASE TELL US IN THE NOTES SECTION BELOW

Name of mortgage company

*Approx sum owing on mortgage (IF NONE STATE "NONE")

Monthly payment

*Current mortgage arrears (IF NONE STATE "NONE")

Highest arrears in past 12 months (IF NONE STATE "NONE")

Loan / Overdraft Details - if you have a secured loan or overdraft.

Do you have any secured loans or overdrafts?

select Yes No

Loan company / bank

Amount outstanding

Current payment arrears (IF NONE STATE "NONE")

Payment Insurance

Insurance protection is not available with this loan, if you require insurance you should seek the services of a specialist insurance provider.

Please write in the box below any notes you think may be relevant to your application..

NOTES

Where did you hear about us?

In sending this application you warrant the information stated to be correct and understand it will form the basis of any agreement. I/we have read the information below.

Disclosure & Use Of Your Information

It is important you read the information in our Data Protection notice, this explains how your data will be used.

I/we confirm that the information given in this application is accurate and that you, or any related finance/ mortgage company to whom you submit this application, may use and disclose my/our data as described in the Data Protection notice.

Unless you tick the box below both we and any other related finance / mortgage company we may refer your application to, may write to you offering products which we or they feel may be of interest to you.

I/we do not wish to receive correspondence from you offering other products which you think may be of interest to me/us.