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9-11 St James St.
Derby, Derbyshire
DE1 1QT

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01332 595 522

or Email us at:
help@moneymanagersuk.co.uk

UNSECURED LOANS

QUESTIONNAIRE

( * = Fields required )
APPLICANT
Name*
Address*
Home Phone*
Mobile*
Date of Birth*
Client Email*
NI Number*
ADDRESS AT TIME OF AGREEMENT (if dierent from present)
Address*
CREDIT AGREEMENT
Lender name*
Account No*
Method of Sale*   (ie phone/branch/internet)
Current Balance* £
1 What was the purpose of the loan?
2 Were you told that you had to clear arrears to previous creditors / mortgage providers?
  Yes     No      Don't know
3 If yes, was the loan used to pay off the arrears and who paid them, ie the loan provider or you?
  Yes     No      Don't know
4 What happened during the sale?
5 Who did you speak to?
6 When did it occur?
7 Where you sold insurance on the loan?
  Yes     No      Don't know
8 What happened during the sale of the insurance?
9 Were you asked if you were unemployed or on a fixed term/temp/ or short contract?
  Yes     No      Don't know
10 Were you asked if you were under 18 or over 65?
  Yes     No      Don't know
11 Were you asked if you were covered by pre-existing insurance?
  Yes     No      Don't know
12 Were you asked if you are effected by any health condition which may prevent you entering in to an insurance policy?
  Yes     No      Don't know
13 Was any paperwork provided with the loan agreement detailing their terms and conditions of the PPI?
  Yes     No      Don't know
14 Were you told that if you wanted to take out the PPI insurance you had to do it at the same time as signing the agreement?
  Yes     No      Don't know
15 Were you given to believe that if you did not take out the policy you would not get the credit applied for?
  Yes     No      Don't know
16 Were you provided with details of the terms and conditions of the policy?
  Yes     No      Don't know
17 Were you told how long the policy would run for?
  Yes     No      Don't know
18 Were you advised that the policy might not continue for the full period of the agreement and that you may be left uncovered?
  Yes     No      Don't know
19 Were you told that your policy premium plus interest on the premium would be paid before any aspect of your credit is paid off?
  Yes     No      Don't know
20 Were you told of the nature of the relationship between the lender and the insurer and if they were the same?
  Yes     No      Don't know
21 Did you sign documents, other than your application?
  Yes     No      Don't know
22 Did the application show the total of the credit and insurance?
  Yes     No      Don't know
General Information:
 I/We confirm that the answers to the above questions are correct to the best of our knowledge
 
Name*  
If joint applicants both sign
 
Name