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Please complete this fact find electronically if possible and email to: [email protected]

Personal/ Company details

First Name:

Last Name:

Email:

Phone:

Mobile:

Is the application on a personal basis or on behalf of a company?:

Amount required (€)::

Is there a key date the funds are needed by?:

Please indicate below how long you will need the funds::

What the loan is to be used for?:

Please give brief details as to how the loan will be repaid.:

This section for internal use.

1.Loan Details 2.Borrower Information (Applicant 1/ Applicant 2)

3.Domestic Residence

Residential Address
Postcode
Time at present address
Value of residential property	Rs.
Outstanding mortgage	Rs.
Monthly payment	Rs.
Are there any arrear?	Rs.
Lender

(Application 2)

4.Employment Details(Applicant 1)

(Applicant 2)

5.Self Employed/Company Applicant

6.Credit History 7.Solicitors Details

8.Property to be Used as Security

If Already Owned with Charges Against Security
Full Address of Security
Postcode
Title Number(If known)
Security Description
Advised Value
Recent Valuation Report?	Yes No
Open Market Value	Rs.
Name of Lender(1st)
Amount Outstanding
Payments	Rs.
Payment Up to Date?	Yes No
Arrears	Rs.
Name of Lender(2nd)
Amount Outstanding
Payments	Rs.
Payment Up to Date?	Yes No
Arrears	Rs.
If Property is to be Purchased
Purchase Price	Rs.
Deposit Paid/To Pay	Rs.
If different to advised value please explain?
Source of balance of funds.
Vendors Name.
Is the property being purchased a new build?	Yes No
Do any of the applicants or their family intend to reside in security?	Yes No
If the loan is to complete a development is there a breakdown of costs?	Yes No

9.Repayment Method for the Bridging Loan

If Property is to be Sold
Is the security being marketed already?	Yes No
Marketed by whom?
If Property is to be Refinanced
Is there a refinance offer already in place	Yes No
With which lender?
Gross Developed Value?
Advised Rental Yield?
Are there sufficient funds to cover a six-month loan period?	Yes No

Amount Requested	Rs.
Term Requested	Months
Loan Purpose	Purchase Refinance Capital Raise Further Advance
Interest payment to be	Service Rolled-up Retained
Date funds required by
Security for loan	Residential(regulated) Residential(non regulated) Commercial Land

Has a mortgage ever been refused on the security property?	Yes No
Has a judgement for debt ever been recorded against the borrower?	Yes No
(Applicant2)	Yes No
Have you ever been declared bankrupt or subject to an IVA?	Yes No
(Applicant 2)	Yes No
Are you currently in arrears on any loan?	Yes No
(Applicant 2)	Yes No