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

Company Name
Company Number
Registered Office
Telephone number
Fax Number
Name of Director
% of shares
DOB
Marital Status
Tel Number
Mob Number
Email
Home Address
Years at this address
Note: If less than 3 years, please provide previous address details
Current property value £
Mortgage Amount
Name of Lender
Name of Director
% of shares
DOB
Marital Status
Tel Number
Mob Number
Email
Home Address
Years at this address
Note: If less than 3 years, please provide previous address details
Current property value £
Mortgage Amount
Name of Lender

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
Tick box for authority to carry out a credit search and agree to terms of service
Mortgage Amount