Full Name

Full Postal Address

Email

Joint Applicant Name (if any)

Telephone (home)

Telephone (work)

Joint Applicant Full Postal Address

National Insurance Number (party 1)

National Insurance Number (party 2)

Date of Birth (party 1)

Date of Birth (party 2)

Is your Agreement with the Lender still live or have you paid it off?

The date of your loan Agreement is sometimes indistinct and I should be grateful if you could tell me the date you entered into it as best you can

Did you actually request payment protection insurance?

Did you at the time of the loan have a job where your wages would have been paid in full were you to be off work through sickness or accident?

If you were pages wages in full, please let us know the name and address os such employer and if applicable, whether you have since changed jobs.

Please stae where you were when the Agreement was made i.e. telephone sale with forms in the post or whether you attended offices of a Broker or the Lender, in which case, please identify the name and address

Can you explain if you did not require payment protection cover, why you agreed to take it out and completed the form accordingly.

Can you send the original or a copy of the payment protection policy and any other insurance linked with the loan if you have retained this?

Did you apply for the loan through a Broker rather than direct to the Lender, and if so, please state name and address and whether the Broker charged you a fee and again, how much was the fee if applicable?