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I have read and accepted the terms and conditions and privacy policy. I confirm that the information concerning my income and outgoings is correct and will not change significantly throughout the loan.

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Thank you for accepting our terms and privacy policy! Your information is in safe hands and may be shared only with our trusted FCA authorized partners and national credit agencies for verification. We truly appreciate your trust!

01. Your Loan Details - No Application Fee

Loan Amount

£300

£1,500

Duration - (Months)

1 month

5 months

Your Next Pay Day *

Following Pay Day *

Borrowing:

£400

Interest:

£142.20

Repayable:

£542.20

Loan repaid by:

Wed 5th Jun 2019

4 payments from 24 Dec 2019 to 4 Jul 2024

£250

1 last payment at 4 Jul 2024 of

£200

02. Personal Details

Title * Mr Mrs Miss Ms Dr

First Name *

Surname *

Day (DD)*

Month (MM)*

Year (YYYY)*

Please enter your date of birth

You can only apply if you are over 18

Email *

Confirm Email *

Home Phone Should start with 01, 02 or 07

Mobile Phone * Should start with 07

Home Address Postcode * Click here to select your address again

Street Name *

Building Number *

Building Name *

City *

Address * Or click here to enter your address manually

Time At Address * 0-6 months 7-11 months 1 year 2 years 3 years 4 years >5 years

Residential Status * Private tenant Owner Council tenent Living with parents Work/School accommodation Owner with Mortgage

Marital Status * Married Single Divorced Widowed Living with partner Separated Other

03. Monthly Income

Net Monthly Salary * Is that your net MONTHLY INCOME?

Your monthly income from work after tax.

Other Income Other income includes any other income or benefits like: Child benefits, Tax Credits, Pension, Overtime, Bonus, Extra work.

This includes a such as benefits, overtime, bonuses, money from a side job, pension etc.

Number of dependants under 18 * 0 1 2 3 4 >5

04. Monthly Outgoings (please only include your contribution)

Food & Other Essentials *

Please provide an estimate for your monthly expense for food and other essentials.

Utilities & Phone *

How much do you spend on gas, electric, water and council tax, home insurance etc.

Transport *

This includes expenses such as public transport, petrol costs, hire purchase payments, car insurance, car maintenance etc.

Other Credit Commitments *

Please include any store cards, credit cards or any other type of credit that not mentioned under Loan Repayments.

Other regular outgoings *

Such as medical, educations, childcare, health and beauty etc.

Monthly Rent / Mortgage *

Please provide accurate monthly/rental expenses.

I confirm that I have £XXX available monthly to make my loan repayments

05. Employment Details

Job Title *

Company Name *

Work Phone Should start with 01, 02, 03 or 08

For employment verification purposes. All your dealings with QuickLoansExpress.co.uk are kept strictly confidential.

Work Email

Work Website

Work Address Postcode * Click here to select your address again

Input your postcode.

Work Street Name *

Work Building Number *

Work Building Name *

Work City *

Address * Or click here to enter your address manually

06. Bank account (where your wages are paid into)

Bank Name *

Sort Code *

Please state your bank sort code to receive funds.

Account Number *

Please state your bank account to receive funds.

Card Type *

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