First Applicant

Name:               Mr Ms Mrs

Date of Birth:   

Marital Status: 

Postal Address: 

Phone No:         

Fax No:             

Mobile No:        

Email:               

First Time Buyer:            Yes         No

Second Applicant

Name:               Mr Ms Mrs

Date of Birth:   

Marital Status: 

Postal Address: 

Phone No:         

Fax No:             

Mobile No:        

Email:               

First Time Buyer:            Yes         No

Self Employment Details

Trading Name: 

Address:        

Date of Commencement of Business:

Gross Income:             £

Nature of Previous Employment:

Self Employment Details - Second Applicant

Trading Name: 

Address:        

Date of Commencement of Business:

Gross Income:             £

Nature of Previous Employment:

Employment Details

Employer:       

Address:        

Occupation:    

How long employed:       

Salary:                       £

Bonus:                       £

Overtime:                   £

Commission:                £

Other Taxable Income:  £

Total:                        £

            Permanent? Contract?  

             Part-time?   Probation?

Other Income:            £

Employment Details - Second Applicant

Employer:       

Address:        

Occupation:    

How long employed:       

Salary:                       £

Bonus:                       £

Overtime:                   £

Commission:                £

Other Taxable Income:  £

Total:                        £

            Permanent? Contract?  

             Part-time?   Probation?

Other Income:            £

Mortgage Details

Type of Product:                    Endowment Annuity

Type of Rate:                            Variable Fixed

if fixed, state fixed term:

Reason for Loan:

Purchase Price/Valuation:£

Finance Required:          £

Balance:                      £

Refinance:                                       Yes No

if yes, indicate type:       Switching None Equity Release Debt Consolidation

From what institution:    

Balance with that institution:

                                  £

Details Of Property to be Mortgaged

Address:        

if a new property,

Is it registered with the Home Bond Scheme?                                        Yes No

Stage Payments?                             Yes No