Please complete the following application. It will be sent to MoneyTalk
only when you complete it and click submit.

Section 1
Your Details

name

Address


Postcode

Home Telephone

Work

Mobile

DOB

National Ins. Number

Job Title

Employer

name and ages of dependants
Dep. 1

Dep. 2

Dep. 3

Dep. 4
 
 
Section 1
Your Partners Details

name

Address


Postcode

Home Telephone

Work

Mobile

DOB

National Ins. Number

Job Title

Employer

name and ages of dependants
Dep. 1

Dep. 2

Dep. 3

Dep. 4
 
 
 
 

 

Section 2
Property Details


Are you a home Owner  
     
House Value  
     
Mortgage Outstanding  
     
Secured Loan or other charge (if any)  
     
Equity  
     
H.P. amount Outstanding  
     
Name and address of Mortgage Provider  
     
 



 



Section 3
Vehicle Details

 

Are you a vehicle Owner  
     
Approximate Vehicle Value [£]  
     
Make and Model  
     
Year of Manufacture  
     
Registration Number  
     
H.P. amount Outstanding  
     
Name and address of H.P. Company  
     
 



 
Section 4
Any Other Asset Details

 

     
Please list any other assets that ate od value.
ie endowment policies, stocks & shares, other property

please do not include household furniture etc
 

 



 

Section 5

Your Unsecured creditors. Please list all those who you owe money to.
Include ALL Credit Cards, personal loans, trade supplies, council tax, other taxes and money borrowed from family and friends. If legal action is planned or threatened by any of these please make a note in the comments box


Creditors Name
Account Number
Amount Owed
Who is liable
Comments
         
         
         
         
         
         
         
         
         
         



 


Section 6

Income and Expenditure.
Please give us details of all your sources of income and reasonable expenditure


Your Monthly Income Your Monthly Expenditure
       
Your Net Income Mortgage/Rent
       
Partners Net Income 2nd Mortgage
       
Child Benefit Loans [secured
       
Other Endowment
       
Other Life Insurance
       
Other Council tax
       
Other Water/Gas/Elec
       
Other House keeping
       
Other TV rent/Licence
       
    Travel
       
    School/Work Meals
       
    Clothing
       
    Telephone
       
    HP 1
       
    HP 2
       
    Other
       
       
TOTAL TOTAL



 
7 Please Submit the form


Your email address please

 



 


if you are after advice when completing this form please call us on

08000 850758