Capital Plan - Online Decision in Principle

Introducer details
Introducer Name *
Company Name *
Telephone Number *
Mobile Number *
Fax Number *
Email *

Loan Details
Loan Amount *
Purpose of Advance *

Applicants Details
Applicant 1 Full Name *
Date Of Birth *	Day:	Month:	Year:
Position in Business *
Percentage of ownership *
Home address 1st line *
Home address 2nd line
Home address Town *
Home address postcode *
Length of residence *	Years:	Month:
Contact telephone *
If less than 3 years at current address
Previous address 1st line
Previous address 2nd line
Previous address Town
Previous address postcode

Applicant 2 Full Name
Date Of Birth	Day:	Month:	Year:
Position in Business
Percentage of ownership
Home address 1st line
Home address 2nd line
Home address Town
Home address postcode
Length of residence	Years:	Month:
Contact telephone
If less than 3 years at current address
Previous address 1st line
Previous address 2nd line
Previous address Town
Previous address postcode

Business Details
Type of entity *
If other please give details *
Trading as
Trading address 1st line *
Trading address 2nd line
Trading address town *
Trading address postcode *
Business telephone *
Fax
Email *
Is there a separate billing address? *
If Yes, billing address 1st line
Billing address 2nd line
Billing address town
Billing address postcode
Company registration number
Length of ownership *	Years:	Month:

Banking and card terminal details
Bank name
Bank account number
Bank town
Bank Sort Code
Contact name
Telephone No.
Visa/Mastercard volume last month
Visa/Mastercard volume last 12 months
Number of terminals
Existing account number
Card processor/acquirer

Additional Business Information
Is the client up to date with their rent or mortgage payments for the business? *
If "No", current status?
What are the daily hours of operation of the business? *
What days of the week are they open? *
Has the Merchant or its Directors:
Filed for bankruptcy protection? *
Contemplating filing for Bankruptcy? *
Entered into or contemplating a voluntary arrangement (personal or business)? *
Entered into or contemplating a reorganisation of the business? *
Entered into or contemplating an assignment for the benefit of a creditor? *
Any pending, threatened or recently filed claims or judgements? *

Data protection

Data Protection Act - please read to one applicant

I need to ask your permission for Capital Plan to carry out credit searches on your application. This is done to verify the information you've given us with credit reference and fraud prevention agencies. These verifications are recorded by them, and so it's important that you don't give us any inaccurate information.

(READ IF MORE THAN ONE APPLICANT/DIRECTOR)
If you disclose information about a joint applicant, you are confirming you are entitled to do so. If you and your joint applicant live at the same address, the credit search will link your financial records and this could be taken into account in any future finance applications either of you make.

Other companies that you go to for credit, insurance or other financial products may see these records. May we have your permission for this search and for Capital Plan to store your information on their computer systems and files?

Please confirm you have read the Data Protection Act information to the applicant(s) and they have agreed to proceed on this basis. *