Confirmation of
Partial repayment
For personal customers and corporate customers
1 Your account details
Please write clearly in the white spaces with capital letters or cross the boxes.
Name of customer(s) (or business name if applicable) Loan account number
First customer
-
-
L
Second customer
Contact telephone number Email address
( )
2 Your partial repayment information
Partial Payment amount:
Currency Amount
D
D
/
M
M
/
Y
Y
Y
Y
This includes my regular payment amount
I will make my regular payment as a separate transaction in addition to this amount
Payment Method
Bank/Telegraphic/Wire Transfer Intended Transfer Date:
Fixed/Term Loans only
Please value the payment to my next payment date
(please provide copy of remittance advice when available)
D
D
/
M
M
/
Y
Y
Y
Y
Current Direct Debit arrangement (maximum limits may apply)
On my next payment date only: Other date:
Please collect this amount each payment due date:
3 Your source of funds details
Funds from third party
Relationship with customer
Purpose of payment
Income/bonus
Profession
Annual Income
Bonus
Sale of other properties
Address of property
Sale of investment
Details of investment
Others
Please specify
4 Your confirmation
I/We confirm that I/we have read and understood the Important Notice below and the instruction will be processed in accordance with
the Banking Services terms and conditions.
Please print name Please print name
First customer
Second customer
Your signature Additional signature if required by your signing instructions held
with the Bank
D
D
/
M
M
/
Y
Y
Y
Y
D
D
/
M
M
/
Y
Y
Y
Y
December 2023 v1.0
I would like the payment to be immediately upon receipt of funds and
consent to any applicable funding break charges being applied to the loan
D
D
/
M
M
/
Y
Y
Y
Y
December 2023 v1.0
5 Important notice
Please return this form via one of the following methods:
By post: Lloyds Bank plc, IMS Customer Service, PO Box 3413, Sheffield,
South Yorkshire, S4 7YB, United Kingdom
By email: ims@lloydsbank.co.uk
1. For “Principal + Interest” with fixed tenure repayment type loans, please
inform us if you wish to keep the future repayment amount remain
unchanged.
5.
It is the Bank’s legal obligation to obtain details on source of repayment.6.
Where the signing instructions for your account require instructions to be
given to us by more than one account holder/authorised signatory, please
ensure that all necessary persons complete and sign Section 5 (‘Your
confirmation’) below before returning this form to the Bank.
7.
We may contact you on receipt of this form for further information to
support the payment, such as documents providing source of funds. If you
have these available please send them to us with this form.
8.
Partial repayment notification should reach us at least 6 working days for
current payment method using GBP Direct Debit arrangement, or 3
working days for other payment methods, prior to the intended partial
repayment date.
2.
Partial repayment monies must be credited to the Bank’s account on or
before the specified partial repayment date under advice to us. Any late
receipt of funds will be subject to overdraft interest.
3.
In the event that the currency of the funds received is different from that of
the loan currency, the Bank shall apply the prevailing exchange rate to
convert the funds received.
4.
