Request a Quote for a Secured Loan

Fields marked with an asterisk (*) are required fields, and must be completed before submitting the form.

Applicant 1

* Name:	First name			Middle name	Surname
Date of Birth:		DD/MM/YYYY
Sex:		Male:	Female:
Marital Status:
* Address:
* Postal Code:
* Years at this Address:
* Previous Address if less than 3 yrs at current Address:
* Previous Postcode:
* Years at this Address:
* Home Telephone:
Work Telephone:
Mobile:
* E-mail Address:
* Preferred method of contact?:

Applicant 2 (If applicable)

* Name:	First name			Middle name	Surname
Date of Birth:		DD/MM/YYYY
Sex:		Male:	Female:
Marital Status:
* Address:
* Postal Code:
* Years at this Address:
* Previous Address if less than 3 yrs at current Address:
* Previous Postcode:
* Years at this Address:
* Home Telephone:
Work Telephone:
Mobile:
* E-mail Address:
* Preferred method of contact?:

Employment Status Applicant 1

* Are you?
* Annual Income?
* Other Income:

Employment Status Applicant 2 (If applicable)

* Are you?
* Annual Income?
* Other Income:

Mortgage Information

* Outstanding Mortgage:	£
* Current Monthly Payment:	£
* Present Value:	£
Purchase Date:	DD/MM/YYYY
Type of Property?
Is the Property ex-council?
What is your Highest arrears in the last 12 months?:
Any further Information :

Credit History

* Do you have CCJ's defaults or arrears?
* Do you have any pending court proceedings against you?
* If you answered Yes to any of the above questions, Please Give further details.

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Please note: By sending us your information you agree to a representative from Tees Valley Finance Ltd or it's associated companies contacting you. We do not send nor sell your details to unconnected third parties, nor will you receive any marketing material as a result of submitting this form.