Name:

Date of Birth:

Marital Status:

Smoker: Yes No

Current Address (including post code):

Own/ Rent/ Parental Home : Own Rent Parental Home

Time at current address :

Previous address (if less than 3 years):

Daytime contact number:

Evening contact number:

Mobile
contact number:

Email Address :

Name:

Date of Birth:

Marital Status:

Smoker: Yes No

Current Address (including post code):

Own/ Rent/ Parental Home : Own Rent Parental Home

Time at current address :

Previous address (if less than 3 years):

Daytime contact number:

Evening contact number:

Mobile
contact number:

Email:

Are you a: First Time Buyer Remortgaging Mover Buying a second property

Are you on the electoral roll : Yes No

Purchase Price:

How much do you want to borrow :

Over how many years :

Do you have a deposit available : Yes No

If so how much do you have :

What are your total outgoings per month:

How much is your current mortgage:

With which lender is your current mortgage:

What is the rate of interest

Type of loan:

Are there any penalties if you transfer or repay your existing mortgage now? Yes No Not Sure

Is your existing mortage portable to a new property? Yes No

Address of the property to be mortgaged:

Number of Bedrooms:

Number of additional rooms:

Year built (if known)