| Residential status (MUST be Homeowner) |
|
| Loan Amount (£) |
|
| Repayment Period |
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| Purpose of Loan |
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| Years with your bank |
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| Date of birth |
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| Marital Status |
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| Employment Status |
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| Years in present job |
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| Occupation |
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| Annual income before tax |
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| Do you have any additional income? |
Yes
No |
| If yes, how much is this annually |
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| Source of this income |
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| Proof of income if self-employed (for the past 3 years) |
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| Title |
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| Forename |
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| Middlename |
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| Surname |
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| Maiden Name |
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| Mothers Maiden Name |
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| Address line 1 |
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| Address line 2 |
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| Town/City |
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| County |
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| Postcode |
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| Home Tel |
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| Mobile Phone No |
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| E-mail address |
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| When to contact |
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| Best time of day to call |
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| Is the property jointly owned? |
Yes
No |
| 2nd Applicant Title |
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| 2nd Applicant Forename |
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| 2nd Applicant Middle Name |
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| 2nd Applicant Surname |
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| 2nd Applicant Maiden Name |
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| 2nd Applicant Date of birth |
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| 2nd Applicant Marital Status |
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| 2nd Applicant Home Tel |
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| 2nd Applicant Mobile Phone No |
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| 2nd Applicant Email |
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| 2nd Applicant Best time to call |
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| 2nd Applicant Years with bank |
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| 2nd Applicant Years with employer |
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| 2nd Applicant Annual Income |
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| 2nd Applicant Employment Status |
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| 2nd Applicant Address line 1 |
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| 2nd Applicant Address line 2 |
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| 2nd Applicant Town/City |
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| 2nd Applicant County |
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| 2nd Applicant Postcode |
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| Number of years you have lived in your home |
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| Previous address line 1 |
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| Previous address line 2 |
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| Town/City |
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| County |
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| Postcode |
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| Property Value |
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| Number of bedrooms |
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| Purchase date |
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| Purchase price |
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| Property type |
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| how many storeys? |
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| Type of walls |
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| Was the property previously owned by the council? |
Yes
No |
| Did you purchase as a sitting tenant? |
|
| What did the council value the property at for the purchase? |
|
| What discount did you receive from the council? |
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| Have you ever previously had a mortgage? |
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| Mortgage Type |
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| Mortgage Company |
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| Mortgage Amount |
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| Mortgage Balance |
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| Monthly Mortgage Payment |
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| Years remaining on mortgage |
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| Months remaining on mortgage |
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| Have you had arrears on your mortgage in the last 12 months? |
Yes
No |
| What are the present arrears on your mortgage? |
|
| What is the highest your arrears have been in the last 12 months? |
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| Have you made your last 3 payments on time? |
Yes
No |
| Other loans secured on property |
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| Secured Loans Company |
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| Secured Loans Amount |
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