Fillable Consolidation Form 1. YOUR DETAILS (Complete FS)

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Consolidation Form 1. YOUR DETAILS (Complete FS)

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Consolidation Form Date of Issue: October 2019 | Version: 3 | Page 1 of 2
Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and Prudential Regulation Authority (Firm reference number 719354).
Consolidation Form
1. YOUR DETAILS
Applicant 1: Applicant 2:
Title: Surname: Title: Surname:
Forenames: Forenames:
Address: Address:
Postcode: Postcode:
2. OUTSTANDING CREDIT
Please note that repayments to creditors will be made based on the details provided below – please ensure that they are correct and up to date.
Consolidating your debt may increase the amount you pay back overall and extend the repayment period of your debts.
Type
(e.g. card, loan)
Date opened Balance (approx) Credit
card limit
Monthly
repayment
Repay? Balance to
repay?
Company name Account no.
£ £ £
£ £ £
£ £ £
£ £ £
£ £ £
£ £ £
£ £ £
£ £ £
£ £ £
Total to be consolidated £
Consolidation Form Date of Issue: October 2019 | Version: 3 | Page 2 of 2
Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and Prudential Regulation Authority (Firm reference number 719354).
3. DECLARATION
1. I/We conrm that the above details are true to the best of my/our knowledge.
2. I/We conrm that I/we will repay the outstanding credit as indicated above from the loan, including, in particular, any credit that needs to be cleared in order to ensure that the loan is
aordable to me/us.
Applicant 1 Applicant 2
Signature: Signature:
Print name: Print name:
Date: Date:
Your property may be repossessed if you do not keep up repayments on your mortgage.
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Consolidation Form 1. YOUR DETAILS (Complete FS)

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Completed 5 April 2021

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