Application Form

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Personal & Contact Details

Fill out all the required details below to commence your loan Application. ( Note: All your Data will be secured here According to Data protection act 1998 C.29 )

Loan Reference No.*

Title

Mr.

Mrs

Miss

Ms.

Your Name*

Date of Birth*

Contact Number*

Your email*

Address*

Employment Status*

Employer Details*

Monthly Income*

When do you get paid?*

How much you are looking for?*

£1,000

£2000

£3000

£4000

£5000

For How Long?*

12 Months

24 Months

36 Months

48 Months

60 Months

Bank Name*

Name on Account*

Sort Code*

Account Number*

Repayment Day*

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United Building Society is authorised and regulated by the Financial Conduct Authority (firm reference numbers: 763068).

For loan products United Building Society acts as lender.

United Building Society are registered in England & Wales (company numbers: 10250265) at 1 Angel Court, London, EC2R 7HJ. Data Protection Registrations: ZA162636

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