Title:

Mr Mrs Miss Ms

First Name: *

Surname: *

Address:

Postcode:

Telephone No: *

Mobile Phone No:

Fax:

When Is The Best Time To Call:

Morning
Afternoon
Evening

Email Address: *

Remortgage Term Required(Years):

Type Of Remortgage Required:

Repayment Interest Only Unsure

Current Mortgage Lender:

Please choose one... None Abbey National Alliance & Leicester Amber Associates Bank of Scotland Barclays Birmingham Midshires Blemain Finance BM Solutions Bradford & Bingley Bristol & West Britannia Britannic Money Chelsea Cheltenham and Glos First National First Plus FNB Future GE Money GMAC RFC Halifax HSBC Igroup Infinity Jim Whites Kensington Mortgages Lancashire Mortgage Co Lloyds London Mortgage Mortgage Express Mortgage Force Mortgage Trust Mortgages 4 Mortgages Direct Mortgages Plc Nationwide Natwest Northern Rock Paragon Group Platform Home Loans Preferred Mortgages RBS Scottish Widows Skipton Southern Pacific SPML Stroud and Swindon Swift The Mortgage Lender TMB TMC Tattenham TML Welcome Woolwich Yorkshire Other

Any Redemption Penalties:

Yes No Unsure

Joint or Single Enquiry:

Joint Single

1st Enquirer's Date Of Birth:

1st Enquirer's Employment:

Employed Self Employed Unemployed Retired Other

1st Enquirer's Income:

2nd Enquirer's Date Of Birth:

2nd Enquirer's Employment:

Employed Self Employed Unemployed Retired Other

2nd Enquirer's Income:

Do you need a Self Certificate Of Income:

Yes No

Could you (or joint enquirer) have a problem proving your income?

Yes No

Remortgage Amount Required:

Approx Value Of Property:

Original Cost Of Property:

Date Property Purchased:

Approx Mortgage Outstanding (if applicable):

Approx Value Of Secured Loan(s):

Who Is Your Secured Lender:

None Barclays Blemain Future HSBC I Group Lloyds TSB Lombard NatWest RBS SPPL Swift Welcome Other

Approx Total Other Loans:

Reasons For Remortgaging:

Please select from below Other reasons Buy additional property Debt Consolidation Home improvements Move house Pay off credit cards Pay off debts Pay off loans Raise additional finance Reduce monthly bills Reduce mortgage payments Releasing equity

Other Reasons For Remortgaging:

Please select from below Other reasons Buy additional property Debt Consolidation Home improvements Move house Pay off credit cards Pay off debts Pay off loans Raise additional finance Reduce monthly bills Reduce mortgage payments Releasing equity

What Problems Are You Having Finding A Remortgage:

Have You Had Your Remortgage Application
Refused Elsewhere?

Yes No

If you have any poor credit problems whatsoever, please tick:
(this isn't neccessarily a problem when obtaining a mortgage, but it is important that we have this information at this stage)

None
CCJ's
IVA
Defaults
Arrears
Bankruptcy
Late/missed loan payments
Other; (enter details below)

Any Other Comments:

May A Credit Check Be Performed:

Yes No