Customer Information Form

1) Loan Details

Loan Amount Required

Purpose - Purchase or Remortgage

Term Required

Loan Type

Reason for remortgage

2) 1st Applicant Details

Title

First Name

Surname

Previous Name

Date Of Birth

National Insurance No

Marital Status

2nd Applicant Details

Title

First Name

Surname

Previous Name

Date Of Birth

National Insurance No.

Marital Status

3) 1st Applicant Residency Details

Home Address

Postcode

Time at Address

Email Address

Home Number

Mobile Number

2nd Applicant Residency Details

Home Address

Postcode

Here for

Email Address

Home Number

Mobile Number

4) Property to be mortgaged

Address - Please write "TBA" if still looking for a property. Or if remortgage of current residential property write "Property Above"

Postcode

If remortgage Date Purchased

Purchase Price

Current Value

Property Type

If Flat, total number of floors in block

If Flat, what floor is it on?

If Flat, does block have a lift?

No. Of Bedrooms

No. Of Receptions

No. Of Kitchens

No. Of Bathrooms

If the security address is a Buy to Let please provide rental per month.

Has the security ever been owned by the council? Yes No

Yes No

Is the security address of traditional construction? (If no give details in additional notes below)

Yes No

5) Current Mortgage Details (Ignore if you are a first time buyer)

Lender Name

Current Balance

Repayment Type

Intrest Only Capital Repayment

Date of loan

Monthly mortgage payment

If in arrears in last 3 years, how many missed payments?

Highest Arrears £ (Last 12 months)

Give information of any arrears in last 3 years

6) CCJ’s/Defaults

Name of Company

CCJ/Default

Amount

Date registered

Date settled

Name of Company

CCJ/Default

Amount

Date registered

Date settled

Name of Company

CCJ/Default

Amount

Date registered

Date settled

Name of Company

CCJ/Default

Date settled

Amount

Date registered

7) YOUR OUTSTANDING CREDIT DETAILS

Lender

Term

Original Loan/credit limit

Current Balance

Monthly Payment & Will TheThis Be Settled

Have you missed any payments in the last 3 years, if yes please give details

8) EMPLOYMENT DETAILS

Applicant 1

Occupation

Employment status

Time in current Position

Gross Annual Income £

Employment Type

2nd Applicant

Occupation

Employment status

Time in current Position

Gross Annual Income £

Employment Type

Details of any additional income

9) EXPENDITURE

Number of children under 18 years old?

Buildings and contents insurance

Ground rent/service charge Maintenance

child support

Council tax Gas, Electricity,

Shopping including food, drinks, tobacco

Transport including fares, petrol, maintenance, tax and insurance

Communication including mobile phones, interest, and digital TV

Clothing and footwear Entertainment

Any other expenses

Total

10) PROPERTY PORTFOLIO (Other properties owned)

Property Address Property value Monthly Rental Income Monthly Mortgage Payment Lender Name Current Mortgage Balance AST or Holiday Let Tenanted

11) INSURANCE POLICIES Life Insurance and Buildings & Contents you already hold

Policy Holder Type of Insurance Policy Number Sum Assured Monthly Payment

Additional Notes