ENQUIRY FORM

Intermediary Details

Company Name
Contact Name
Telephone Number
Mobile Number
Email Address
Broker fee

Loan Details

Purpose of Loan
Loan Amount
Term of Loan
How will the loan be repaid

Applicants Details - Applicant 1

Title
Full Name
Residential address
D.O.B
Marital Status
Tel
Mob
Email
Any adverse credit
Net income
Years at this address
Property value: £
Lender
Balance Outstanding

Applicats Details - Applicant 2

Title
Full Name
Residential address
D.O.B
Marital Status
Tel
Mob
Email
Any Adverse credit
Net income
Years at this address
Property Value: £
Lender
Balance Outstanding

Proposed Security

Address
Housing
Property Description
Current Property Value £
Purchase / Refinance
Purchase Price £
1st charge / 2nd charge
Freehold / Leasehold
Length of lease (years)
Current Mortgage Lender
Balance Outstanding
Rental Income
Do you own additional property
Who will occupy the property
Relationship to applicant
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