Amount £: Term:
Adverse credit (CCJs, Defaults etc)? Yes No
Type of mortgage: Purchase Remortgage RTB Buy to Let

1ST APPLICANT

Mr Mrs Miss Ms First Name:
Surname:
Date of birth: Day: Month: Year:
Current Address:

Home Tel: Work Tel:
Mobile:
Email:
Previous address (if less than 3 years at current address):

Occupation:
Annual income £:
Employers name and address:

Period of employment: years months

2ND APPLICANT (if applicable)

Mr Mrs Miss Ms First Name:
Surname:
Date of birth: Day: Month: Year:
Current Address:

Home Tel: Work Tel:
Mobile:
Email:
Previous address (if less than 3 years at current address):

Occupation:
Annual income £:
Employers name and address:

Period of employment: years months

PROPERTY / SECURITY

Type of building: House Flat Bungalow Maisonette
If flat, is it: purpose built converted
If flat, state floor number: and number of floors:
If applicable, is the building: detached semi terraced

Leasehold / freehold: leasehold freehold
If lease, state how many years:

Ex Local Authority? Yes No

Purchase price £: Current price £:

RENT MORTGAGE

Rent / mortgage payment, per month: £
Mortgage outstanding: £ Current arrears: £
Current lender:

ADVERSE CREDIT

CCJs:
1)
2)
3)
4)
Defaults:
1)
2)
3)
4)

Bankrupt? yes no - If yes, no. months discharged: months
IVA? yes no - If yes, current settled