Type Of Enquiry ( Please put an (x) in the boxes which apply to your enquiry
Loan Type ie fixed, disc:
Purchase:
Re-Mortgage:
Right To Buy:
Buy To Let:
Let To Buy:
1st Time Buyer:
Self-Cert:
Not 1st Time Buyer:
Personal Details
First Applicant - Personal Details
Title
Forename:
Surname:
Other Name:
Date Of Birth:
Marital Status
Second Applicant - Personal Details
Title
Forename:
Surname:
Other Name:
Date Of Birth:
Marital Status
First Applicant - Contact Details
Daytime Contact No:
Evening Contact No:
Email Address:
Second Applicant - Contact Details
Daytime Contact No:
Evening Contact No:
Email Address:
First Applicant - Current Address
Address:
Town:
Country:
Post Code:
Second Applicant - Current Address
Address:
Town:
Country:
Post Code:
First Applicant - Previous Address if current less than 3yrs
Address:
Town:
Country:
Post Code:
Second Applicant - Previous Address if current less than 3yrs
Address:
Town:
Country:
Post Code:
Is The Property A Flat:
Above Commercial:
Is The Property A Flat:
Above Commercial:
Loan Details
Product Required :
Purchase Price:
Value If RTB:
Current Mortgage Balance:
Loan Amt Required:
Loan To Value ie 95%:
Purpose Of Further Borrowing:
First Applicant - Last 2 Years Net Profits or Total Annual Income
Applicant 1 Salary:
Year 1 Net Profit:
Year 2: Net Profit:
Joint Income:
Is the Proposed Security:
Flat
Second Applicant - Last 2 Years Net Profits
Applicant 2:
Year 1 Net Profit:
Year 2 Net Profit:
S / Cert Income :
Storeys of flat:
Other Existing Debts
Lender
Amount
To Be Re-Paid On Completion
(If Not) Monthly Repayment
Bal O/S ()
End Date
Challenge to Overcome:
Defaults:
IVA:
Missed Payments:
CCJs:
Bankruptcy:
Provide full details of above ccj's,defaults,missed payment,bankruptcy,iva including Dates, Amounts, when registered
and if satisfied.
Introducer Name
I have read the Data Protection statement and confirm that I understand it fully and confirm that I have authorised a credit check. (Do not tick box if no credit check is requested)
