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New Customer Application

Step 1 of 6

16%
  • If you are employed, we will need to see evidence of this. For example, bank statements.

  • If you are self employed, we will need to see evidence of this. For example, bank statements.

  • Incomings - Please note anything you put here we will need to see proof of for it to be considered in your application.

    Please list all your incomings. If you receive a joint benefit claim please split the amount by 50% (for example if you and your partner get £100 ESA between you then please just put £50 for you).
  • Outgoings

    Please list all your outgoings - If you split any of these with a partner, we just need to know the part that YOU pay. If someone else pays this then please leave it blank.
  • We need to know if anyone at the address you live at pays towards the outgoings with you.
  • Please Select
  • We need to know how much you pay towards your rent. If Money is paid directly from your benefits we just need to know what extra you pay towards this.
  • We need to know how much you pay towards your Council Tax? If Money is paid directly from your benefits we just need to know what extra you pay towards this.
  • If this is included in your rent please select 'This Doesn't Have To Be Paid At all'
  • If this includes anything like Sky, Broadband etc please include everything.
  • If this was included in your phone bill please select 'this doesn't have to be paid at all'
  • This includes a food shop at a supermarket, lunches during the week, dinners etc. If you have a family this is the whole amount for them.
  • Please put an average for the week/month
  • This could be childcare costs, after school clubs pocket money etc.
  • This will be things like pet food, pet toys, Insurance etc
  • Name of Company You Have The Loan WithAmount You Pay BackHow Often Do You Pay This? 
  • NameRelationship to you 
  • Responsible Lending

    We want to make sure that you can afford repayments on this loan. To decide if you can afford this, we will use information on your finances as they are right now.

    Is something in your life about to change?
    Future changes in your life may make it harder for you to make repauments. For example: working fewer hours, retirement, redundance, or getting less money, divorce or separation, a child or someone else you take care of joinging your household.

    If you have any changes you're expecting then please phone us on 01708 755490 and let us know.

    I'm not aware of any changes to my circumstances which may have an impact of my ability to manage this loan. *

    By submitting this form you confirm that you can afford to make the repayments on the loan.

    If you do not understand anything on this form please call one of our team on 01708 755490

    By ticking this box you give permission for one of the team at Cockle Finance to visit you at your home address to discuss a loan with you. *



    Important Information

    Cockle Finance is authorised and regulated by the Financial Conduct Authority, 25 North Colonnade, Canary Wharf Group, London, E14 5HS.

    It is also a member of the Consumer Credit Association, Queens House, Queens Road, Chester, CH1 3BQ.

    Data - How to find out more

    Cockle Finance will use the information provided to determine whether or not to issue you with a loan. To do this we may use Callcredit or Experian to perform a credit search.

    Cockle Finance will not share your data with anyone else.

    For full details on how your data may be used please contact the Consumer Credit Association or the agencies below (they may charge a small statutory fee).

    Callcredit - Consumer Services Team, PO Box 491, Leeds, LS3 1WZ or call 0870 060 1414 or visit www.callcreditcheck.co.uk

    Experian - Consumer Help Services, PO Box 8000, Nottingham NG80 7WF or call 0844 481 8000 or visit www.experian.co.uk


  • Please note that if you are struggling financially and are borrowing money for that reason, your loan application will not be accepted.
  • Cockle Finance has teamed up with UK Credit Ratings, you can check your credit report & credit score for free. To check your credit report for free, click the image below:

  • We offer a recommend a friend scheme so if you're accepted, the person who recommended you could get a £10 Love2Shop voucher!
Cockle Finance
Office 130, 176 South Street, Romford
Essex, RM1 1BW

T: 01708 755490     E: enquiries@cocklefinance.co.uk


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