APPLICATION FORM

APPLICATION FORM
SUBMITTING INTERMEDIARY DETAILS
COMPANY NAME
CONTACT NAME
EMAIL ADDRESS
CONTACT NUMBER
IS A BROKER COMPLETION FEE BEING CHARGED?
BROKER FEE AUTHORITY
INTERMEDIARY FIRM
BROKER FEE AMOUNT
BY CONFIRMING BELOW, YOU AUTHORISE 9Y CAPITAL LIMITED AND THEIR SOLICITORS TO MAKE A PAYMENT ON COMPLETION OF THE ABOVE AMOUNT, TO THE INTERMEDIARY LISTED ABOVE FOR THE SERVICES THEY HAVE PROVIDED TO YOU.
DATE

DayMonthYear
PRINT NAME
BORROWER DETAILS
IS THE BORROWER A LIMITED COMPANY OR INDIVIDUAL(S)?
COMPANY NAME
COMPANY NUMBER
SIC CODE
IF NOT UK REGISTERED, COUNTRY OF INCORPORATION

FOR COMPLEX COMPANY STRUCTURES, PLEASE PROVIDE A COMPANY STRUCTURE CHART.

THE FOLLOWING SECTION: ‘APPLICANT / COMPANY GUARANTOR INFORMATION’ WILL NEED TO BE COMPLETED FOR ALL COMPANY DIRECTORS AND THOSE WITH A SHAREHOLDING OF 20% OR MORE IN THE COMPANY.
APPLICANT / COMPANY GUARANTOR INFORMATION
- NAME
  
  TitleFirst & Middle Name(s)Last Name
- PREVIOUS NAME OR ALIAS
- DATE OF BIRTH
  
  DayMonthYear
- CURRENT DATE
  
  DayMonthYear
  Date
- CURRENT ADDRESS
  
  Street Address
  
  Street Address Line 2
  
  Town / CityState / Province
  
  Post Code
- APPLICANT 1 AGE
- PREVIOUS ADDRESS
  
  Street Address
  
  Street Address Line 2
  
  Town / CityState / Province
  
  Post Code
- HAVE YOU LIVED AT THIS ADDRESS FOR LESS THAN 3 YEARS?
- PERMANENT RIGHT TO RESIDE IN THE UK?
- CONTACT NUMBER
- EMAIL ADDRESS
- NATIONAL INSURANCE NUMBER
- PASSPORT NUMBER
- EMPLOYMENT DETAILS
- NAME OF EMPLOYER
- ANNUAL INCOME
- NAME
  
  TitleFirst & Middle Name(s)Last Name
- PREVIOUS NAME OR ALIAS
- DATE OF BIRTH
  
  DayMonthYear
- APPLICANT 2 AGE
- CURRENT ADDRESS
  
  Street Address
  
  Street Address Line 2
  
  Town / CityState / Province
  
  Post Code
- PREVIOUS ADDRESS
  
  Street Address
  
  Street Address Line 2
  
  Town / CityState / Province
  
  Post Code
- HAVE YOU LIVED AT THIS ADDRESS FOR LESS THAN 3 YEARS?
- PERMANENT RIGHT TO RESIDE IN THE UK?
- CONTACT NUMBER
- EMAIL ADDRESS
- NATIONAL INSURANCE NUMBER
- PASSPORT NUMBER
- EMPLOYMENT DETAILS
- NAME OF EMPLOYER
- ANNUAL INCOME
- NAME
  
  TitleFirst & Middle Name(s)Last Name
- PREVIOUS NAME OR ALIAS
- DATE OF BIRTH
  
  DayMonthYear
- APPLICANT 3 AGE
- CURRENT ADDRESS
  
  Street Address
  
  Street Address Line 2
  
  Town / CityState / Province
  
  Post Code
- PREVIOUS ADDRESS
  
  Street Address
  
  Street Address Line 2
  
  Town / CityState / Province
  
  Post Code
- HAVE YOU LIVED AT THIS ADDRESS FOR LESS THAN 3 YEARS?
- PERMANENT RIGHT TO RESIDE IN THE UK?
- CONTACT NUMBER
- EMAIL ADDRESS
- NATIONAL INSURANCE NUMBER
- PASSPORT NUMBER
- EMPLOYMENT DETAILS
- NAME OF EMPLOYER
- ANNUAL INCOME
- NAME
  
  TitleFirst & Middle Name(s)Last Name
- PREVIOUS NAME OR ALIAS
- DATE OF BIRTH
  
  DayMonthYear
- APPLICANT 4 AGE
- CURRENT ADDRESS
  
  Street Address
  
  Street Address Line 2
  
  Town / CityState / Province
  
  Post Code
- PREVIOUS ADDRESS
  
  Street Address
  
  Street Address Line 2
  
  Town / CityState / Province
  
  Post Code
- HAVE YOU LIVED AT THIS ADDRESS FOR LESS THAN 3 YEARS?
- PERMANENT RIGHT TO RESIDE IN THE UK?
- CONTACT NUMBER
- EMAIL ADDRESS
- NATIONAL INSURANCE NUMBER
- PASSPORT NUMBER
- EMPLOYMENT DETAILS
- NAME OF EMPLOYER
- ANNUAL INCOME
- LOAN DETAILS
- PURCHASE OR REFINANCE?
- LOAN AMOUNT REQUIRED
- LOAN TERM REQUIRED
- SERVICING METHOD
- IF PART & PART, PLEASE CONFIRM RETAINED PERIOD
- WHERE WILL INTEREST PAYMENTS BE MADE FROM?
- PURCHASE PRICE
- IS THIS A BELOW MARKET VALUE TRANSACTION
- DEPOSIT SOURCE (SELECT ALL THAT APPLY)
- IF 'OTHER' WAS SELECTED, PLEASE CONFIRM SOURCE OF DEPOSIT
- PREVIOUS PURCHASE PRICE
- DATE PURCHASED
- CURRENT MORTGAGE BALANCE
- PLEASE CONFIRM THE USE OF ANY LOAN PROCEEDS OVER & ABOVE THE CURRENT MORTGAGE BALANCE
- HOW DO YOU INTEND TO REPAY THE LOAN?
- PLEASE CONFIRM WHETHER THERE IS A SPECIFIC DATE YOU WOULD LIKE TO COMPLETE THE LOAN
  
  DayMonthYear
- SECURITY DETAILS
- PROPERTY ADDRESS
- ESTIMATED CURRENT MARKET VALUE
- FIRST OR SECOND CHARGE
- PROPERTY TYPE
- TENURE
- DESCRIPTION OF PROPERTY
  (PLEASE LET US KNOW IF THERE ARE ANY OTHER FACTORS TO TAKE INTO CONSIDERATION, I.E. NON-STANDARD CONSTRUCTION, EX LOCAL AUTHORITY ETC.)
- IS THE PROPERTY CURRENTLY LET?
- PASSING RENT (PA)
- INTENTIONS FOR THE PROPERTY / PLANNED WORKS DURING THE LOAN TERM
- PLEASE PROVIDE NAME & CONTACT DETAILS FOR THE VALUER TO GAIN ACCESS
- WOULD YOU LIKE TO ADD ADDITIONAL SECURITY?
- ADDITIONAL PROPERTY ADDRESS
- ESTIMATED CURRENT MARKET VALUE
- FIRST OR SECOND CHARGE
- PROPERTY TYPE
- TENURE
- DESCRIPTION OF PROPERTY
  (PLEASE LET US KNOW IF THERE ARE ANY OTHER FACTORS TO TAKE INTO CONSIDERATION, I.E. NON-STANDARD CONSTRUCTION, EX LOCAL AUTHORITY ETC.)
- IS PLANNING PERMISSION IN PLACE FOR THE WORKS?
- PLANNING REFERENCE NUMBER (IF AVAILABLE)
- CURRENT GIA OF PROPERTY
- PROPOSED GIA OF PROPERTY
- BUILD COSTS (EXCLUDING CONTINGENCY)
- CONTINGENCY
- S106 / CIL
- PROFESSIONAL FEES
- GROSS DEVELOPMENT VALUE (GDV)
- ESTIMATED POST WORKS RENTAL INCOME (PA)
- CONTRACTOR DETAILS
- ESTIMATED DURATION OF WORKS
- SOLICITOR DETAILS
- NAME OF FIRM
- CONTACT NAME
- TELEPHONE NUMBER
- EMAIL
- ADDRESS
- CREDIT HISTORY
- HAS THE APPLICANT(S), BORROWING COMPANY, OR ANY OF THE DIRECTORS, SHAREHOLDERS OR GUARANTORS:
- EVER BEEN REFUSED A MORTGAGE ON A PROPERTY?
- MISSED A MORTGAGE OR SECURED LOAN PAYMENT WITHIN THE LAST 12 MONTHS?
- EVER HAD A CCJ (COUNTRY COURT JUDGEMENT) OR ANY OTHER DEBT FORMALLY RECORDED AGAINST THEM?
- EVER BEEN DECLARED BANKRUPT OR BEEN A DIRECTOR OR SHAREHOLDER OF A COMPANY PLACED INTO LIQUIDATION OR ADMINISTRATION?
- EVER BEEN SUBJECT TO AN IVA (INDIVIDUAL VOLUNTARY ARRANGEMENT) OR CVA (COMPANY VOLUNTARY ARRANGEMENT)?
- EVER FAILED TO KEEP UP PAYMENTS ON A MORTGAGE OR LOAN?
- EVER BEEN CONVICTED OR CHARGED WITH AN OFFENCE OTHER THAN A DRIVING OFFENCE?
- EVER HAD A PROPERTY REPOSSESSED?
- EVER BEEN A DIRECTOR OR SHAREHOLDER OF A COMPANY IN WHICH A RECEIVER OR LIQUIDATOR HAS BEEN APPOINTED?
- BEEN ASSOCIATED WITH A BUSINESS THAT HAS FAILED TO KEEP UP REPAYMENTS ON A MORTGAGE, CREDIT CARD OR OTHER FINANCIAL ARRANGEMENT, BEEN INSOLVENT OR HAD A COURT ORDER FOR DEBT REGISTERED AGAINST IT?
- ADDITIONAL INFORMATION (IF THE ANSWER TO ANY THE ABOVE IS ‘YES’ PLEASE PROVIDE INFORMATION BELOW)
- ADDITIONAL SUPPORTING INFORMATION
- PLEASE PROVIDE ANY FURTHER INFORMATION WHICH MAY SUPPORT THE APPLICATION
- PLEASE UPLOAD ANY SUPPORTING INFORMATION FOR THE APPLICATION
  
  Cancelof
- PRIVACY NOTICE
- A COPY OF OUR PRIVACY NOTICE IS AVAILABLE TO REVIEW HERE
- MARKETING PREFERENCES
- We sometimes produce useful material about the property market along with changes to legislation and regulation. Please tick below if you would like to receive this information:
- We would also like to keep in touch with you about our products and services which may be of interest. Please tick below if you would like to receive this information:
- DECLARATIONS
- PLEASE TICK BELOW TO CONFIRM THAT YOU DO NOT CURRENTLY LIVE AT THE SECURITY ADDRESS AND YOU HAVE NO INTENTIONS TO RESIDE IN THE PROPERTY
- PLEASE TICK THE BOX TO CONFIRM THAT THIS LOAN IS WHOLLY OR PREDOMINANTLY FOR THE PURPOSE OF A BUSINESS CARRIED ON, OR INTENDED TO BE CARRIED ON BY YOU
- I declare that the replies to the questions in this application form and any supplementary form(s) are true and complete in every respect to the best of my knowledge and I understand that the lender has relied on the replies and that these may form the basis of any contract between me and the lender and its transferees and assignees.
  
  I hereby acknowledge that I have reviewed and understood 9Y Capital Limited's Privacy Notice, which outlines how my personal data will be collected, processed, and used.
  
  I consent to 9Y Capital Limited processing and using my personal data in accordance with the terms described in the Privacy Notice.
  
  Please call us on 0203 839 5012 if you want to understand how your data will be used.
  
  You have a legal right to receive a copy of the information we hold about you.
- FULL NAME
- DATE
  
  DayMonthYear
- I declare that the replies to the questions in this application form and any supplementary form(s) are true and complete in every respect to the best of my knowledge and I understand that the lender has relied on the replies and that these may form the basis of any contract between me and the lender and its transferees and assignees.
  
  I hereby acknowledge that I have reviewed and understood 9Y Capital Limited's Privacy Notice, which outlines how my personal data will be collected, processed, and used.
  
  I consent to 9Y Capital Limited processing and using my personal data in accordance with the terms described in the Privacy Notice.
  
  Please call us on 0203 839 5012 if you want to understand how your data will be used.
  
  You have a legal right to receive a copy of the information we hold about you.
- FULL NAME
- DATE
  
  DayMonthYear
- I declare that the replies to the questions in this application form and any supplementary form(s) are true and complete in every respect to the best of my knowledge and I understand that the lender has relied on the replies and that these may form the basis of any contract between me and the lender and its transferees and assignees.
  
  I hereby acknowledge that I have reviewed and understood 9Y Capital Limited's Privacy Notice, which outlines how my personal data will be collected, processed, and used.
  
  I consent to 9Y Capital Limited processing and using my personal data in accordance with the terms described in the Privacy Notice.
  
  Please call us on 0203 839 5012 if you want to understand how your data will be used.
  
  You have a legal right to receive a copy of the information we hold about you.
- FULL NAME
- DATE
  
  DayMonthYear
- I declare that the replies to the questions in this application form and any supplementary form(s) are true and complete in every respect to the best of my knowledge and I understand that the lender has relied on the replies and that these may form the basis of any contract between me and the lender and its transferees and assignees.
  
  I hereby acknowledge that I have reviewed and understood 9Y Capital Limited's Privacy Notice, which outlines how my personal data will be collected, processed, and used.
  
  I consent to 9Y Capital Limited processing and using my personal data in accordance with the terms described in the Privacy Notice.
  
  Please call us on 0203 839 5012 if you want to understand how your data will be used.
  
  You have a legal right to receive a copy of the information we hold about you.
- FULL NAME
- DATE
  
  DayMonthYear
- WOULD YOU LIKE TO SHARE THIS FORM?
- WOULD YOU LIKE TO SHARE THIS FORM?
- ENTER NEXT APPLICANT’S EMAIL ADDRESS BELOW AND SUBMIT THE FORM FOR THEM TO RECEIVE A LINK TO EDIT THE FORM.
- EMAIL ADDRESS OF THE NEXT APPLICANT TO COMPLETE FORM:
- PLEASE NOTE THAT IF YOU SHARE THIS FORM WITH SOMEONE, ALL OF THE INFORMATION YOU HAVE COMPLETED WILL BE VISIBLE TO THEM, INCLUDING ANY PERSONAL INFORMATION.
- MESSAGE FOR NEXT APPLICANT (OPTIONAL)

Rows	NAME	SHAREHOLDING (%)	PG AVAILABLE	ROLE PERFORMED IN COMPANY
DIRECTOR 1
DIRECTOR 2
DIRECTOR 3
DIRECTOR 4

APPLICATION FORM

SUBMITTING INTERMEDIARY DETAILS

BROKER FEE AUTHORITY

BORROWER DETAILS

APPLICANT / COMPANY GUARANTOR INFORMATION

LOAN DETAILS

SECURITY DETAILS

SOLICITOR DETAILS

CREDIT HISTORY

HAS THE APPLICANT(S), BORROWING COMPANY, OR ANY OF THE DIRECTORS, SHAREHOLDERS OR GUARANTORS:

ADDITIONAL SUPPORTING INFORMATION

PRIVACY NOTICE

MARKETING PREFERENCES

DECLARATIONS

WOULD YOU LIKE TO SHARE THIS FORM?