PERSONAL DETAILS

Full name

Loan reference number

(If known)

Date of birth

Email address

Telephone number

Address

Postcode

YOUR CIRCUMSTANCES

Please answer Yes or No to the following questions.

Have your circumstances changed due to COVID-19?

YesNo
If yes, please tell us why you need support to manage your loan repayments and one of our team will contact you.

Has your individual income changed?

YesNo
If yes, please provide more information.

Has your household income changed?

YesNo
If yes, please provide more information.

Have you been made redundant since 1st March ? (Will not return to your previous job)

YesNo

Are you on Furlough Leave – this is where you remain employed but are currently not at work or unable to work?


YesNo

Will you be returning back to work after 31 March?


YesNo

IF you are due to return back to work, will this be on reduced hours?


YesNoN/A

Are you self-employed and unable to trade at the moment?

YesNo

If you are self employed, what other financial support have you applied for?

Current loan instalment?

Frequency of payment

WeeklyFortnightly4 WeeklyMonthly

Are you currently in arrears?

YesNo

What support are you asking for?

Reduced paymentsPayment holidayExtend my loan termEarly settlementA further loanDon't know

What level of payment plan can you afford?

Are you receiving help from an Approved Mental Health Professional due to your finances?

YesNo

*If repaying your finances is impacting your mental health and you are not currently in request of a debt respite, please contact an Approved Mental Health Professional, more details can be found from your Local Authority.

Please use the space below to tell us any other information that will help us consider your request as quickly as possible.

Other information

Conduit recognise the uncertainties and challenges that many customers will face in the coming months due to Covid-19 and we are here to support you and your individual circumstances.

Please leave this field empty.