Short Term Advance Loan Application Form printable pdf download

Short Term Advance Loan Application Form

SHORT TERM ADVANCE LOAN APPLICATION FORM

SECTION 1: Your details

Your name:

Constituency:

SECTION 2: Loan amount required

Amount of loan applied for

(maximum £4,000)

£______________________

SECTION 3: Repayment plan and agreement

Your loan must be repaid to IPSA by 31 March 2016. When you take out the loan we will set up a

regular deduction from your salary. This will start on the date your next salary payment is due, and

continue to the end of the financial year with the final payment being deducted on 31 March 2016.

If for any reason an amount remains outstanding by 31 March 2016 it will become a debt and we will

seek to recover it in accordance with our debt recovery policy.

Please complete the table below to confirm you understand the repayment arrangement and that

you agree for a regular payment to be deducted from your salary. If you would like to set up a

payment plan that ends before 31 March 2016 please indicate the date you would like the last

payment to be made.

I understand that my loan must be repaid in full by 31 March 2016



and I give permission to IPSA to deduct a regular sum from my

Please tick:

salary.

The amount deducted will be equal to the amount of loan paid,

divided by the number of months remaining in the financial year.

We will write to you to confirm the exact amount once we have

processed your application.

If the loan is being repaid over a shorter period (i.e. before 31

Enter date of last

March 16) please indicate the date you would like your last

payment

payment to be made.

_____/_____/_____

Short Term Advance Loan Application Form