| Agent/Introducer | |
| Telephone Number | |
| Email Address | |
| Where did you hear of us | |
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In order to provide you with a quick response as to whether you meet our lending criteria, please provide us with the information requested below. If we approve your information, we will send a complete Application Form to you.
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Applicants
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| Applicant One | Applicant Two |
| Name | | |
| Address | | |
| Postcode | | |
| Time at this Address | | |
| Work Number | | |
| Home Number | | |
| Mobile Number | | |
| Date of birth | | |
| Marital Status | | |
| Are you a smoker? | | |
| Do you require Currency Transfer? | | |
| No of Dependants | | |
| Email Address | | |
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Employed
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| Applicant One | Applicant Two |
| Name of employer | | |
| How long employed | | |
| Gross/net income. | | |
| Job title | | |
| Permanent or Temporary | | |
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Self Employed
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| Applicant One | Applicant Two |
| Nature of business | | |
| Established since | | |
| Net profit Latest Year | | |
| Year prior to above | | |
| Year prior to above | | |
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Financial Details (Assets & Income)
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| Applicant One | Applicant Two |
| Savings | | |
| Value of current home | | |
| Mortgage Outstanding | | |
| Monthly repayment | | |
| Others (maintenance, private pension) | | |
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Commitments
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| Applicant One | Applicant Two |
| Rent income/outgoings | | |
| Bank Loans-amount outstanding
& monthly payment | | |
| Credit Cards payments per month | | |
| Maintenance received/paid | | |
| Other Commitments | | |
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Details of any adverse (County Court Judgement, Defaults, Missed Mortgage Payments, please specify dates
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Proposed Property Purchase
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| Applicant One | Applicant Two |
| House, Flat, Apartment, Villa, Other | | |
| Purchase price | | |
| Amount of loan required | | |
| Source of Deposit | | |
| Mortgage term required | | |
| Address of property | | |
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If you wish to add any information relevant to your application, or clarify answers given above. Please use the space below.
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YOUR HOME MAY BE REPOSSSESSED IF YOU DO NOT KEEP UP REPAYMENTS ON YOUR MORTGAGE
OR ANY OTHER DEBT SECURED ON IT
CHANGES IN THE EXCHANGE RATE MAY INCREASE THE STERLING EQUIVALENT OF YOUR DEBT
THIS IS NOT A REGULATED MORTGAGE CONTRACT UNDER FINANCIAL SERVICES AUTHORITY RULES SO YOU WILL NOT BE PROTECTED BY THEM IN RESPECT OF IT |
Please type in the box the secuirty code:

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