Test-formLoan Enquiry Form – Test Bank Statement How did you hear about us? * Please select …GoogleFriendFamily MemberExisting CustomerComparison Site Your friend or family member * Please supply the full name of the person that recommended you. Amount you’d like to borrow? (£) * 100* Credit limits are subject to an affordability assessment. Reason for needing the loan … * Please select …One-off PurchaseHolidaySpecial OccasionHome Appliances / RepairsHome Improvements / RepairsVehicle Expense / RepairsFuneralRent / UtilityUnexpected BillsBaby / Child CostsMedical / DentalEducationBusiness Expenses Please specify … * Your personal details … Title * Please select …MrMrsMissMs First Name * Last Name * Date of birth * Home Tel. Number Mobile Tel. Number * Email Address * Your household details … Marital Status * Please select …MarriedSingleDivorcedLiving with PartnerWidowedSeparated How many dependents do you have? * Please select …None12345 or more Residential Status * Please select …Home OwnerPrivate TenantCouncil TenantHousing AssociationLiving with ParentsOther Please check the Areas We Cover page to see if we cover your area. (opens in new tab)Home Address * Home Address Home Address Home Address Town Town City City Postcode Postcode Time at your current address * Please select …Less than 1 year1 – 2 years2 – 3 years3 – 4 years4 – 5 yearsOver 5 years Previous Address * Previous Address Previous Address Previous Address Town Town City City Postcode Postcode Time at your previous address * Please select …Less than 1 year1 – 2 years2 – 3 years3 – 4 years4 – 5 yearsOver 5 years Your financial details … Employment Status * Please select …Full-timePart-timeSelf-employedOn BenefitsRetired Employer’s Name * Job Title * How long have you been in your current employment? * Please select …Less than 1 year0 – 1 year1 – 2 years2 – 3 years3 – 4 years4 – 5 years5 years or more How often do you receive your income? * Please select …WeeklyFortnightlyFour-weeklyMonthly How often do you receive your benefits? * Please select …WeeklyFortnightlyFour-weeklyMonthlyAt different times in the month Weekly Income (after tax / other deductions) * £ Fortnightly Income (after tax / other deductions) * £ Four-weekly Income (after tax / other deductions) * £ Monthly Income (after tax / other deductions) * £ How much money you receive in total per week? * £ How much money you receive in total per fortnight? * £ How much money you receive in total per four-weeks? * £ How much money you receive in total per month? * £ Are you expecting an increase / decrease in income over the next 6 months? * Please select …No ChangeIncreaseDecrease What would you estimate your regular monthly expenses add up to? * £ Please select …0 – 100100 – 200200 – 300300 – 400400 – 500500 – 600600 – 700700 – 800800 – 900900 – 10001000 – 15001500 – 20002000 or more Include priority payments such as mortgage/rent, council tax, utilities, supermarket shop, TV/internet services, transport/vehicle expenses, children and clothing etc How much do you spend on loans, credit cards, buy-now-pay-later services, catalogues or hire purchase agreements? (within one calender month) * £ Please select …00 – 100100 – 200200 – 300300 – 400400 – 500500 – 600600 – 700700 – 800800 – 900900 – 10001000 or more How much do you spend on gambling, lottery or betting services? (within one calender month) * £ Please select …00 – 100100 – 200200 – 300300 – 400400 – 500500 – 600600 – 700700 – 800800 – 900900 – 10001000 or more Have you had any County Court Judgements (CCJs) in the last 5 years? * Please select …YesNo Have you entered into an Individual Voluntary Arrangement (IVA), Debt Management Plan (DMP), Debt Relief Order (DRO) or declared bankruptcy in the last 5 years? * Please select …YesNo Permissions I consent to an agent or representative contacting me by phone or by request, visit me at my home to complete my application. * Please select …YesNo As part of our application process, we require a representative of Brantwood Finance to make contact with you either by phone or in person in order to complete a full application and evidence your income and outgoings.If you answered ‘No’ to this question, we cannont consider your application. I consent to Brantwood Finance performing a soft credit search if required. * Please select …YesNo We will let you know if we perform such a search and which Credit Agency we have used. https://www.brantwoodfinance.co.uk/privacy-policy/As part of our application process as we have to perform a credit search to verify certain information you provide.We will inform you which Credit Agency we have used during the application process.If you answered ‘No’ to this question, we cannont consider your application. I consent to Brantwood Finance sending communications by SMS, WhatsApp or Email to provide details about my application, loans and any product-specific promotions. * Please select …YesNo I consent to a bank statement being used as part of my affordability assessment and loan evaluation and I confirm that the bank statement I upload is an official statement downloaded directly from my online banking or mobile banking app. * Please select …YesNo We cannot consider your application without a full and current bank statment.If you answered ‘No’ to this question, we cannont proceed with your application. Upload Bank Statement – Month 1 (PDF only) Upload Bank Statement – Month 2 (PDF only) Upload Bank Statement – Month 3 (PDF only) Please read before submittingBy submitting this form, if we feel we can help you, you will receive a call back from a representative within 4 working days. If you do not hear from us within this time, unfortunately we are not able to proceed with your application.If you’re accepted in principle, a member of our team will call you to finish your loan application. This could be done over the phone or at your home with an assigned Agent.DisclaimerI confirm that I am at least 21 years old and a UK resident. By completing the Loan Enquiry Form, I confirm that I am not in an Individual Voluntary Arrangement (IVA) or Debt Management Scheme or currently declaring bankruptcy and that all of the information I have provided to you is true.If I receive a call back from Brantwood Finance Company in relation to my enquiry, I understand and agree that, prior to the full completion of my application and the release of any loan monies, an Agent of Brantwood Finance Company will contact me or visit me at my home address to complete an affordability assessment and consumer credit agreement. This is the contractual agreement I agree to enter when receiving a loan from Brantwood Finance Company.Loan amount and length of term requested is subject to change pending an affordability assessment. Data Protection StatementWe are required by the Data Protection Act to keep your personal details confidential and the information you provide will only be used to make a decision on whether to lend you money. Credit Reference and Fraud Prevention AgenciesWe may check your details and credit rating with credit reference agencies – and you will have the right to know which credit reference agency we use. We may also use the information you provide to prevent fraud, money laundering and debt tracing. Submit If you are human, leave this field blank.
