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Sr. No.

Name

Phone

Business Name

Current Status

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View Details

1 Customer Info
2 Business Info
3 Loan Info

Personal Details:

Title:* {{ errors.first('title') }}

First Name:* {{ errors.first('first name') }}

Middle Name:

Last Name:* {{ errors.first('last name') }}

Phone:* {{ errors.first('phone') }}

Email:* {{ errors.first('email') }}

Date of Birth:* The date of birth must be in the format dd-mm-yyyy

Marital status:

Number of dependents

Identification document

Driver's license

Your Driver's license

Download x

Your Driver's license

Download x

Passport

Your Passport

Download x

Your Passport

Download x

Residence Details:

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County:* {{ errors.first('County') }}

Address:* {{ errors.first('address') }}

Town/City:* {{ errors.first('town/city') }}

Postal Code:* {{ errors.first('postal code') }}

Years at Home Address:

Ownership:

Proof of Home Address:

Council Tax

Your Council Tax

Download x

Your Council Tax

Download x

Your Bank Statement

Download x

Bank Statement

Download x

What is Your Role within the business?

SECURITY:

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Town/City:* {{ errors.first('security town/city') }}

Postal Code:* {{ errors.first('security postal code') }}

Approximate value (GBP/£)

Mortgage outstanding (GBP/£)

Would you be willing to provide a personal guarantee?

Would you be willing to provide a floating charge on the business?

Would you be prepared to give us open banking access to your account?

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Business Details:

Business Name:* {{ errors.first('Business Name') }}

Industry Sector {{ errors.first('Industry') }}

Registration Number:* {{ errors.first('Registration Number') }}

Unique Tax Reference Number (UTR):

Time In Business {{ errors.first('Time in business') }}

Current Monthly Turnover {{ errors.first('Current Monthly Turnover') }}

Date of Incorporation:* {{ errors.first('Date of Incorporation') }}

Registered Address:

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County:* {{ errors.first('County') }}

Business Address:* {{ errors.first('address') }}

Town/City:* {{ errors.first('town/city') }}

Postal Code:* {{ errors.first('postal code') }}

Trading Address:

Registered Address is the same as Trading Address

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County:* {{ errors.first('County_') }}

Business Address:* {{ errors.first('Address_') }}

Town/City:* {{ errors.first('City') }}

Postal Code:* {{ errors.first('postal code_') }}

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County:* {{ errors.first('County_') }}

Business Address:* {{ errors.first('Address_') }}

Town/City:* {{ errors.first('City') }}

Postal Code:* {{ errors.first('postal code_') }}

Years at Business Address:

Website Address:

Monitored Company Email:* {{ errors.first('Monitored Company Email') }}

Switchboard Number:

Please let us know the reason you are looking for funding:

Please outline your future business plan:

Please upload a 12 month forecast (if you have one):

Your 12 month forecast

Download x

Your 12 month forecast

Download x

Director Name 1

Name:

Age:

Email:

Address:

Director Name 2

Name:

Age:

Email:

Address:

Director Name 3

Name:

Age:

Email:

Address:

PLEASE UPLOAD A COPY OF YOUR MOST RECENT ANNUAL FINANCIAL STATEMENTS OR INSERT THE DETAILS BELOW:

Income Statement

Download x

Income Statement:

Last Financial Year

Previous Year

Prior Year

Revenue

Cost of Goods Sold

Gross Profit

Operating Expenses

EBITDA

Non-Cash Expenses

EBIT

Taxes

Net Profit After Tax

Balance Sheet:

Debtors:

Creditors:

Current Assets:

Current Liabilities:

Fixed Assets:

Long-Term Liabilities:

Other Assets:

Other Liabilities:

Total Assets:

Total Liabilities:

Share Capital:

Retained Earnings:

OUTSTANDING FINANCE:

Lender	Amount Outstanding	Remaining Term (in Months)	Type	Fixed Repayment (Monthly)

ADD CREDIT LINES HERE

PLEASE UPLOAD BANK STATEMENTS BELOW:

Bank Statement

Download x

Bank Account:

Name of Bank:

Branch Name:

Branch Number:

Account Type:

Account Number:

Loan Details:

Loan Number:

Loan Type:

Loan Purpose:

Advance Requested:

Minimum Daily Repayment: {{ errors.first('Minimum Daily Repayment') }}

Revenue Repayment Rate(%): {{ errors.first('Revenue Repayment Rate(%)') }}

Repayment term in working days: {{ errors.first('Repayment term in working days') }}

Status Of AIP:

Arrangement Fee (%): %

Payment Processing Fee (%): %

Payment Failure Fee: £

Failed Payment Authorisation Fee: £

Repayment Amount: £

Committee Members:

Start Date

Bank Change Fee: £

Blocked Bank Account Fee: £

Default Fee: £

Committee Date:

Reason of Disapprove Application Form.

Further Information Required.

Next Steps.

Business Cash Advance Statement

Sr No.	Date	Repayments Due	Repayments Made	Outstanding Balance	Action
{{i+2}}		£	£	£

Submit