Secure Application Portal

Application for Short Term Funding

Complete all sections carefully. Your information is processed securely in accordance with UK GDPR and the Data Protection Act 2018.

👤 Personal Details

Please provide accurate personal information for all applicants. Fields marked * are required.

Full Name *

Previous Name (if applicable)

Date of Birth *

Nationality *

Home Address *

Previous Address (if moved within 3 years)

Company Name (if applicable)

Company Reg No (if applicable)

Business Address

Mobile No *

Home Tel No

Work Tel No

E-mail Address *

Bank Details

Bank Name *

Account Number *

Sort Code *

Security & ID

Place of Birth

Mother's Maiden Name

National Insurance Number

Drivers Licence Number

Passport Number

On Electoral Roll? *

Yes No

💼 Employment Details

Income and employment information for all applicants.

Employment Status *

Occupation / Job Title

Business / Employer Name

Business / Employer Address

Accountant's Name & Address

Income

Gross Annual Income (Employment) *

Total Net Monthly Income (after tax) *

Additional Net Monthly Income

Source of Additional Income

Planned / Actual Retirement Age

📊 Applicant Affordability

Monthly expenditure for all applicants. This helps us assess responsible lending.

Monthly Payment	Applicant 1 (£)	Applicant 2 (£)	Applicant 3 (£)
Car / Travel
Existing Mortgage / Rent
Utilities
House Phone
Holiday
Food
Internet
Mobile
Miscellaneous (Sky, subscriptions)
Nursery / Child Care / Maintenance
Insurances
Entertainment
Loans / HP / Credit Cards
Total Monthly Payments
Total Net Monthly Income
Disposable Monthly Income

Dependants

Do you have dependent children?

Yes No

If yes, how many?

Do you care for any dependent adults?

Yes No

If yes, how many?

🔍 Credit History

Please answer all questions truthfully. Providing false information is a criminal offence.

Have you ever been refused a mortgage on the property to be mortgaged or any other property?

Have you ever had a judgement for debt recorded against you, or if self-employed / controlling director, against your company?

Have you ever been bankrupt or compounded with your creditors?

Have you ever failed to keep up your payments under any present or previous mortgage, rental or loan agreement?

Have you ever been convicted of or charged with an offence other than a driving offence?

Has a claim been made to the DSS (Department of Social Security) in the last 12 months?

If you answered YES to any question

Please provide full details

🏦 Assets & Liabilities

Declare all assets and associated debts for both applicants.

Asset Type	Applicant 1 Value (£)	Applicant 1 Debt (£)	Applicant 2 Value (£)	Applicant 2 Debt (£)
1. Private Residential
2a. Investment Property
2b. Investment Property
3. Personal Chattels
4. Bank & Building Society
5. Other Investments
6. Equity / Shares
7. Other
8. Outstanding Tax

🏠 Property Details

Details of the property being offered as security for the loan.

Full Address of Property (Security) *

Detailed Description of Property *

Full names & DOB of all residents during the loan term

Type of Dwelling *

Is there a Garage? *

Yes No

No. of Habitable Rooms

No. of Bedrooms

Estimated Property Value *

Amount Owing on Existing Borrowings

Existing Lender Name

Loan Reference Number

Additional Properties as Security (if applicable)

Property 1 — Full Address & Description

Property 2 — Full Address & Description

Property 1 — Value

Property 2 — Value

Property 1 — Amount Owing

Property 2 — Amount Owing

Payment Options

Payment Method

Payment by Standing Order Borrow Interest Payments

Borrow Interest For (months)

Further Supporting Information

Detailed Explanation of Why Bridging Finance is Required *

⚖️ Solicitor Details

The solicitor's firm must have 2 or more partners.

Name of Solicitor(s) Acting *

Name of Firm *

Full Address of Firm *

Email Address *

Contact Tel No

Contact Mobile No

Fax No

🤝 Broker / Introducer Details

Complete all fields if introduced via a broker or intermediary.

Company Name

Broker Name

FCA Reg No

CCL No

Full Address

Tel No

Mobile No

Proc Fee (£ or %)

Client Meeting Record

Have you met the client directly in regard to this application?

Yes No

Any other comments

📋 Declaration

Please read, understand, and sign the declaration before submitting your application.

Applicant Signatures

Applicant 1 — Print Name *

Applicant 2 — Print Name

Date (Applicant 1) *

Date (Applicant 2)

🔒 This application is transmitted securely. Your data is processed under UK GDPR and the Data Protection Act 2018.

✓

Application Submitted

Thank you for submitting your application for short term funding. Our team at Ponte Finance PLC will review your submission and be in touch within 2 business days.

Reference: PF-2026-XXXXXX

Queries: [email protected] · www.ponte.finance

Application for Short Term Funding

Responsible Lending Statement

Land Registry Consent

Credit Searches & Identity Checks

Fair Processing Notice

Application Submitted