How Much Can You Claim Title:---MrMrsMissMsOther Enter your title: Your First Name(s): Your Last Name: House Number or Name:---1234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950Other Enter Your House Number or Name: Post Code: Daytime Contact Telephone Number: Email Address: You took out a Lloyds:---LoanCredit CardMortgageOverdraftCar LoanBusiness Loan Approximate Amount Borrowed: Average Outstanding Monthly Balance:---Fully Repaid Every Month£1 - £50 Overdrawn£50 - £100 Overdrawn£100 - £250 Overdrawn£250 - £500 Overdrawn£500 - £1,000 Overdrawn£1,000 + Overdrawn Average Outstanding Monthly Balance:---Fully Cleared Every Month£1 - £50£50 - £100£100 - £250£250 - £500£500 - £1,000£1,000 + When did you take this out:---201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985 When did you repay it:---Fully RepaidStill Repaying, all payments up to dateStill Repaying, but in ArrearsStill Repaying by Agreed Reduced PaymentsRepaying or Repaid by Debt Management PlanRepaying or Repaid by IVARepaid by Bankruptcy Year in Which Fully Repaid:---In 2017In 2016In 2015In 2014In 2013In 2012In 2011In 2010In 2009In 2008In 2007In 2006In 2005In 2004In 2003In 2002In 2001In 2000Before 2000 How Much Are These Arrears (or Approximately): Have You Held Any Other Accounts With Lloyds:---NoYes Other Credit CardsYes Other LoansYes Other Credit Cards and LoansYes Other Credit Cards, Loans and Mortgages Do You Still Bank With Lloyds:---YesNo Account closed under 1 year agoNo Account closed over 1 year agoNo Account closed over 2 years agoNo Account closed over 3 years agoNo Account closed over 4 years agoNo Account closed over 5 years agoNo Account closed over 6 years agoNo Account closed over 7 years agoNo Account closed over 8 years agoNo Account closed over 9 years agoNo Account closed over 10 years agoNo Account closed over 11 years agoNo Account closed over 12 years agoNo Account closed over 13 years agoNo Account closed over 14 years agoNo Account closed over 15 years ago Do You Agree To Our Terms & Conditions:---Yes 4 Old Park Lane London W1K 1QW