Business / Asset Finance Enquiry

NOTE: If you need to come back and complete the form at another time, you can do so without losing any information you have already entered. To do this, scroll to the bottom of the form and click the ‘Save your progress and continue later’ link. Just enter your email address and we’ll send you a special link, so that you can come back at a later date using any computer to complete the form. Please note that partially completed forms will only be held for 30 days.

* Indicates a required field. Where a * is not shown, the field may be left empty. Please try however to provide as much information as possible.

Introducer Details

Name*

First Last

Company Name (if applicable)

Telephone Number*

Email Address

FCA Number

Client Details

Client Name*

Company Name*

Company Address*

Street Address Address Line 2 City / Town County Post Code Country

Company Registration Number*

Business Type*

Business Trade*

Number of Years Trading*

Main Contact's Name*

Main Contact's Telephone Number*

Director / Owner's Name*

Is the Director a Homeowner?*

Mortgage*

Value*

Director / Owner's Current Address (3 Years History Required)*

Street Address Address Line 2 City / Town County Post Code Country

Time At Current Address*

Previous Address*

Street Address Address Line 2 City / Town County Post Code Country

Time At This Address*

Previous Address (*If Applicable)

Street Address Address Line 2 City / Town County Post Code Country

Time At This Address (*If Applicable)

Client Requirements

Type of Finance Required*

Term Remaining*

Amount Required*

Purpose of the Funds*

Further Notes for Consideration

If a new/startup-up business, a Business Plan & Projections will be required. If business is established, last full set of Accounts, last 3 months Bank Statements & Management Accounts will be required.

Terms & Conditions*

I have read and agree to the T&Cs and in particular to the data protection clause stating that Black Book Finance Ltd (BBF) will become the Data Controller responsible for client data received for the purpose of pursuing a loan application under the terms of this agreement. By ticking and accepting BBF’s T&Cs you are confirming and consenting that you have your clients’ consent to permit BBF to use your clients data. This is no way affects your own responsibilities as an Intermediary under DPA and GDPR.