Enquiry form

Please complete the form, which takes about 5 minutes, so that
we can start working on your enquiry. You will receive the
news about your enquiry by e-mail as soon as possible.
Fields in red are required, the form will not send without them.

Please note minimum property value Ł50,000

	Applicant 1	Applicant 2
Title
Name/s
Last Name
Marital Status
Date of birth
Are you a British citizen	Yes No	Yes No
Address
Address
City
County
Postcode
Time at address
If you have been at your current address for less than 3 years please give previous address/s

Work telephone
Home telephone
Mobile
e-mail
Current address

Business Details

	Type of business
	Net Income
	Gross Income
	Net loss last 12 months.
	Date business started

Business Type Self employed Partner Limited Co Start up

Company name Company reg no.

Do you wish to self certify Yes No
your income?

the total income stated above will be used to asses your enquiry

Do you have an accountant ? Yes No

No. of years audited accounts available

Credit history

		Applicant 1	Applicant 2
	Have you ever had any CCJ's ?	Yes No	Yes No

A ccj check will now be taken up with Experian
( not a full credit check at this stage)

Have you ever Defaulted on a credit card or loan ?

Yes No

Date of default
Amount of default      Ł                                      Ł
has it been satisfied    Yes No                                      Yes No

Have you had mortgage arrears in the last 12 months ?

Yes No

No. of payments missed
Repayment amount
Amount currently in arrears
Which months in the last 12 were missed ? eg; July, Sempterber and October

Name of current lender

Have you had rent arrears in the last 12 months ?

Yes No

Yes No

No. of payments missed
Repayment amount
Amount currently in arrears
Which months in the last 12 were missed ? eg; July, Sempterber and October

Have you ever been Bankrupt ?

Yes No

Yes No

Date discharged

Have you ever had an IVA ?

Yes No

Yes No

Is this current ?

Yes No

Date completed

Date started
Monthly payment
Any missed payments     Yes No                          Yes No

Have you had a property repossessed in the last 6 years

Yes No

Name of lender that
repossessed

Date of repossession

Is there any outstanding Yes No Yes No
amount owed

Mortgage Details

	Property value	Ł
	Current mortgage amount	Ł
	Name of current lender
	Mortgage amount requiredd	Ł

Repayment typee

Repayment Interest only

Please let us know repayment vehicle
for repaying capital at end of term

Term required

Years

	I would be interested in the following mortgage type

	Lowest start rate
	Fixed rate
	Discount rate

	Please let us have any further information that you feel may help us with your application in the box below

	Please enter here the name of the search engine or keyword you used to find us


	Please confirm that you have read our Terms of business ( click to view) and agree to them

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Think carefully before securing other debts against your home.
Your home may be repossessed if you do not keep up repayments on your mortgage