Southway Solutions
LOAN APPLICATION FORM
Please complete ALL the information in this form and write in BLOCK CAPITALS.
An incomplete form may delay your application. If you need assistance in completing this form please
ask. Once eligibility checks are complete, decisions on lending and the processing and administration
of loans are the responsibility of the Credit Union.
Mr
Mrs
Ms
Miss
Other
Solutions reference No
From Southway Connect
Surname
First name
Date of birth
National Insurance No
Status: Married / Single / Partner
Child Benefit No
Email:
Mobile phone No
Home phone No
YOUR ADDRESS – Please give details of everywhere you have lived in the last 3 years
Current address
Time at this address
Postcode
Years
Months
Previous address
Time at this address
Postcode
Years
No of adults in your household
Months
No of children
e you:
INFORMATION ABOUT YOUR EMPLOYMENT and / or BENEFITS
Are You: Employed
Self Employed
Unemployed
Student
Retired
If not employed go to the next section
a. If employed what is your occupation?
Employer’s name and address
Postcode:
How long have you worked there?
Are you full time / part time?
Years
Months
Are you permanent
temporary/ casual
b. Are you getting any benefits?
If yes, which one/ s?
INFORMATION ABOUT YOUR INCOME
Please include details about all your income including payments from wages, pensions, Tax Credits,
student loans and bursaries, and benefits. If you include your partner’s /spouses income then you
both must sign the loan application and agreement.
Income Eg. From wages / pensions /benefits and Tax Credits
Type
Amount paid
How often paid
Net Salary /wages
£
Company Pension
£
Benefits
£
Tax Credits
£
State Pension
£
Student loan / bursary
£
Other
£
Total
Income per month
ABOUT YOUR LOAN
How much do you want to borrow?
£
What are you borrowing for?
Over how long do you want to repay the loan
Years / Months / Weeks
How often do you want to make repayments?
How do you want to repay?
Weekly
Standing Order
Fortnightly
Benefit deduction
Bank transfer, please give details: Sort Code:
4 weekly
Monthly
Payroll deduction
Account No
Do you have an existing credit union loan?
Y
N
If you have a Credit Union loan.
are you still making repayments?
Y
N
This does not prevent you having a
Southway loan.
If you stopped making repayments
you can still be accepted for a
‘Solutions’ loan but the credit union
will ask you to set up a new
arrangement to repay the loan
IMPORTANT – YOUR PERSONAL INFORMATION
In accordance with the principles of the Data Protection Act 1998, we may use your personal details for the
purpose of managing your accounts with South Manchester Credit Union. Personal details may be shared with
other agencies and subcontractors for the purpose of credit referencing, debt recovery and other operational
reasons for which we hold a consumer credit Licence. If you would like to read the full details of how your data
may be used please visit our web site www.smcreditunion.co.uk or phone 0161 448 0200 or ask one of our staff.
FORMAL DECLARATION – YOUR SIGNATURE
I declare that to the best of my knowledge the information I have given on this form is true, accurate and
complete.
I understand that the provision of false information is fraud and that the Credit Union may take appropriate action,
including the recouping of costs incurred in recovering all sums due under the loan agreement, by any means
deemed necessary. I am not indebted to any other Credit Union, bank or loan agency, except as stated above.
The statements herein are made for the purpose of obtaining a loan.
Applicant
Signature
Print Name
Date
Partner /Spouse – If you have included your partner or spouses income they must sign below.
Signature
Print name
Date
WHAT TO DO NOW
Return this form to South Manchester Credit Union with supporting documentation including:
1. Personal ID (Examples include - Passport, driving licence, benefit entitlement letter, student
ID card)
2. Proof of address (Examples include - Recent utility bill, Council Tax bill, bank statement,
tenancy agreement, UCAS letter).
For the full list of accepted ID see the Credit Union’s ID information sheet. If you have problems
producing accepted documentation please contact the Credit Union who can inform you of other ways
to prove Identity.
South Manchester Credit Union, 187 Fog Lane, Burnage M20 6FJ
www.smcreditunion.co.uk
Phone: 0161 448 0200