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One Applicant Two Applicants
Required Details
Applicant 1
Title
MrMrsMissMsDrOther
First Name
Middle Name
Surname
Maiden / Previous Name
Date of Name Change
National Insurance No.
Nationality
Date of Birth
Smoker
NoYes
Current Address
Current Postcode
Home Phone
Work Phone
Mobile Phone
E-Mail Address
Financial Dependants
None 1 2 3 4 5
Dependant 1 Name
Dependant 1 Date of Birth
Dependant 2 Name
Dependant 2 Date of Birth
Dependant 3 Name
Dependant 3 Date of Birth
Dependant 4 Name
Dependant 4 Date of Birth
Dependant 5 Name
Dependant 5 Date of Birth
Residential Status
Home Owner (No Mortgage)Home Owner (With Mortgage)Private TenantCouncil TenantParental HomeOther
If renting, how much do you pay?
Are you on the electoral roll at this address?
Length of time at current address or date moved in
Previous address if less than 3 years at current address
Page 1 of 9
Next
Please click on this tab if you are employed by a company or business that you do not own
Please click on this tab if you are self-employed as a sole trader or partnership
Please click on this tab if you are employed by a company that you own some or all the shares
Please click on this tab if you receive a pension
Occupation
Time in job
Name of employer
Expected retirement age
Basic annual income (Gross)
Guaranteed overtime/bonus
Regular overtime/bonus
Other income
Please state source of other income
Notes & additional details
Years trading
Name of business
Your expected retirement age
Latest years (pre-tax) net profit
Previous years (pre-tax) net profit
Name of company
Limited company shares
Latest years salary
Latest years dividend
Previous years salary
Previous years dividend
Latest years accounts available
How many years available
Notes
Pensions
None 1 2 3 4 5 6
Pension 1
StatePrivate
Pension 2
Pension 3
Pension 4
Pension 5
Pension 6
Previous
Page 2 of 9
Child Benefit
Child Benefit amount per year
Maintenance
Maintenance amount per year
Tax Credits
Tax Credits amount per year
DLA
DLA amount per year
Are you making any maintenance or child support payments?
Your maintenance or child support payments
Page 3 of 9
Credit Cards
Credit Card 1
Credit Card 2
Credit Card 3
Credit Card 4
Credit Card 5
Credit Card 6
Loan Agreements
Loan Agreement 1
Loan Agreement 2
Loan Agreement 3
Loan Agreement 4
Loan Agreement 5
Loan Agreement 6
Hire Purchases
Hire Purchase 1
Hire Purchase 2
Hire Purchase 3
Hire Purchase 4
Hire Purchase 5
Hire Purchase 6
Any Other Commitments
Any Other Commitment 1
Any Other Commitment 2
Any Other Commitment 3
Any Other Commitment 4
Any Other Commitment 5
Any Other Commitment 6
Page 4 of 9
Food Per Month
Transport / Travel / Fuel / Road Tax Per Month
Leisure / Socialising Per Month
Council Tax Per Month
Water / Gas / Electricity Per Month
Insurances Per Month
Telephone / Mobiles Per Month
Personal Goods Per Month
Clothing Per Month
Tobacco & Alcohol Per Month
Total Per Month
Page 5 of 9
Have you ever had a mortgage or loan application refused?
Details
Have you ever had a judgement for debt or a loan default registered against you?
Have you ever been declared bankrupt or made an arrangement with your creditors?
Have you ever failed to keep up your payments under any previous or current mortgage, rental or loan agreement?
Please provide full details of any CCJ's, defaults, arrears or bankruptcies
Page 6 of 9
Do you have a current mortgage on your home address?
Name of lender
Property value
Mortgage balance
Monthly payment
How long have you owned this property?
Are you tied in to this mortgage?
Date tie-in ends
What is the penalty
Are you prepared to pay this penalty to leave this mortgage?
Is your current mortgage portable?
Page 7 of 9
Do you have any other outstanding Buy to Let mortgage commitments?
None 1 2 3 4
Lender
Property Value
Mortgage Balance
Monthly Payment
Monthly Rent
Page 8 of 9
Can we have your consent to conduct a credit search
Submit Initial Enquiry
Page 9 of 9
Applicant 2
Total
