1. PERSONAL DETAILS Your Full Name:  * Title: Marital Status: Date Of Birth: Nationality: Ages of dependants if any: Home Tel Number: Work Tel Number: Mobile Tel Number:  * Email Address:  * Current residential status (owner/tenant/living with parents/other): Current Address inc. postcode: Previous addresses (last 3 years req'd): Dates at address: Employment status (employed/self-employed/retired/student/other): Occupation: Is your position permanent (yes/no): Date started: Employer's or business name and address: If director please state % shareholding: Previous jobs and dates over the last 12 months: Gross basic income (employed): Net profit projection for this year (self -employed) Net profit last year (self-employed): Net profit 2 years ago (self-employed): Net profit 3 years ago (self-employed): Overtime/Bonus: Other income (i.e. pension/rental/ 2nd job):

Partner's Full Name: Partner's Title: Partner's Marital Status: Partner's Date Of Birth: Partner's Nationality: Partner's age of dependants if any: Partner's Home Tel Number: Partner's Work Tel Number: Partner's Mobile Tel Number: Partner's Email address: Partner's current residential status: Partner's current address inc. postcode: Partner's previous addresses (last 3 years req'd): Partner's dates at address: Partner's employment status: Partner's Occupation: Is your partner's position permanent (yes/no): date partner started: Partner's employer's or business name and address: If partner is a director please state % shareholding: Partner's previous jobs and dates over the last 12 months: Partner's gross basic income (employed): Partner's net profit projection for this year (self-employed): Partner's net profit last year (self-employed): Partner's net profit 2 years ago (self-employed): Partner's net profit 3 years ago (self-employed): Partner's overtime/bonus: Partner's other income (i.e. pension/rental/2nd job):

Name on your bank account: Name of Bank:

Name on partner's bank account: Name of Bank:

Which account will the new mortgage be paid from (you/your partner's):   2. ASSETS. (Please tell us what assets you or your partner own in the following format: Name/Type/Value/To be used towards purchase i.e. John Smith/Savings/£10 000/Yes): Asset 1: Asset 2: Asset 3: Asset 4:

3. CREDIT HISTORY Have you been late with payments on your rent or mortgage or any other loans credit cards or other credit (yes/no): Have you ever received a default? This is a warning letter that if you do not pay court action will commence (yes/no): Have you ever received a County Court Judgement been made bankrupt or had a property repossessed? (yes/no): Have you been refused credit or a mortgage within the last 6 months? (yes/no): Further comments on your credit history:   4. YOUR MAIN RESIDENCE Who owns your main residence: First line of address: Current value: Mortgage lender: Mortgage amount: Payment per month: Mortgage start date: Mortgage end date: Repayment method: Interest rate: Interest rate type: Any early repayment charge? End date?   5. YOUR INVESTMENT PROPERTIES INCLUDING SECOND HOMES AND OVERSEAS PROPERTY. For each property please provide the information in the format specifed below: Property 1: Owner/1st line of address/market value/lender/outstanding mortgage/monthly payment/interest rate/interest rate type/any early repayment charge with end date/monthly rent Property 2: Owner/1st line of address/market value/lender/outstanding mortgage/monthly payment/interest rate/interest rate type/any early repayment charge with end date/monthly rent Property 3: Owner/1st line of address/market value/lender/outstanding mortgage/monthly payment/interest rate/interest rate type/any early repayment charge with end date/monthly rent Property 4: Owner/1st line of address/market value/lender/outstanding mortgage/monthly payment/interest rate/interest rate type/any early repayment charge with end date/monthly rent Property 5: Owner/1st line of address/market value/lender/outstanding mortgage/monthly payment/interest rate/interest rate type/any early repayment charge with end date/monthly rent Property 6: Owner/1st line of address/market value/lender/outstanding mortgage/monthly payment/interest rate/interest rate type/any early repayment charge with end date/monthly rent Property 7: Owner/1st line of address/market value/lender/outstanding mortgage/monthly payment/interest rate/interest rate type/any early repayment charge with end date/monthly rent Comments on your portfolio you think we should know:   6. OTHER DEBTS LOANS CREDIT CARDS STORE CARDS GUARANTORS ETC. Please provide the information in the specified format below: Debt 1: debtor/type of debt/name of provider/balance cleared at end of month(Y/N)?/amount outstanding/monthly payments/end date/do you plan to repay this debt within the next 6 months (Y/N)? Debt 2: debtor/type of debt/name of provider/balance cleared at end of month(Y/N)?/amount outstanding/monthly payments/end date/do you plan to repay this debt within the next 6 months (Y/N)? Debt 3: debtor/type of debt/name of provider/balance cleared at end of month(Y/N)?/amount outstanding/monthly payments/end date/do you plan to repay this debt within the next 6 months (Y/N)? Debt 4: debtor/type of debt/name of provider/balance cleared at end of month(Y/N)?/amount outstanding/monthly payments/end date/do you plan to repay this debt within the next 6 months (Y/N)?   ANYTHING ELSE YOU THINK WE SHOULD KNOW IN CONNECTION WITH YOUR APPLICATION FOR FINANCE Comment Do not enter anything in this field: