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Contact Us

Here are our contact details. Alternatively, you may wish to use the form below to contact us.
Telephone:
+44 (0) 1702 316228
E-Mail:
info@chipsit.co.uk
Address:
205 York Road
Southend
Essex
SS1 2RU
Click here to view map


Online Application Form

Please complete and submit the following form with any comments or queries you may have. Any questions will be answered as soon as possible.

Loan Details

Loan Amount:
£
Loan Term:
Years
Purpose of Loan:


First Applicant Details

Title:
Surname:
First Names:
Date of Birth:
Marital Status:
Current Address:




Postcode
Living Status:
Time Living at Current Address:
Years
Months
Telephone Numbers:
Home
Work
E-Mail Address:


Employment Details - First Applicant

Occupation:
Employment Status:
Gross Annual Income:
(Including overtime/ bonuses/ commission)


Second Applicant Details

Title:
Surname:
First Names:
Date of Birth:
Marital Status:
Current Address:




Postcode
Living Status:
Time Living at Current Address:
Years
Months
Telephone Numbers:
Home
Work
E-Mail Address:


Employment Details - Second Applicant

Occupation:
Employment Status:
Gross Annual Income:
(Including overtime/ bonuses/ commission)

Property Details

Estimated Value:
£
Mortgage/Rent payment:
£ Per calendar month
Current Mortgage Lender:
Outstanding Mortgage Balance:
£
Current Mortgage Arrears (if any):
£
Highest Amount of Mortgage Arrears in last 12 months (if any):
£
County Court Judgements (if any):

Additional Information

Please use the box below to enter any other additional
information/comments/questions you may have: