Request a Quote for Short Term Finance

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

Contact Details

* Name:


		Firstname		Surname

* Address:

* Postal Code:

* Telephone:

Fax:

Mobile:

* E-mail Address:

* Preferred method of contact?:

Company Details

* Company Name:
* Trade Name (If applicable):
* Are you a:
Date business established:	DD/MM/YYYY
* Your main business activities are?
Are the business premises?	If other, please State
Number of Directors:
Number of Employees:
Are Directors CV's available?
Are directors guarantees available?
Are three years accounts available?
Are any draft / Interim accounts available?
Are last 6 months bank statments available?
If you answered yes to any of the above questions, Please give further details.

Short Term Finance Detail

* Reason for short term finance?:
* Any previous experience?:
Property Address to be offered as security:
Description of property?:
Outstanding mortgage on property to be used as security (If applicable):	£
Name of Lender ?
Estimated value / purchase price of property ?	£
Address of other properties to be used as security :
Outstanding Mortgage ?	£
Name of Lender ?
Estimated value / purchase price of property ?	£
Amount of loan required?	£
How long will the loan be needed for ?
Do you want the interest to be rolled-up for the term of the loan ?
Estimated future value of property ?
How will the loan be redeemed?

Solicitors Details

* Solicitors Name?
* Solicitors Address?
Solicitors Telephone?
Solicitors Fax?
Solicitors Email Address?

Credit History

* Have you ever been declared bankrupt ?
* 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.

By submitting this application, I agree to your User Agreement and Privacy Policy.

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.