INTRODUCER DETAILS

INTRODUCER DETAILS
Name

First NameLast Name
Broker Registration Number
Broker fees
Contact Number
Please enter a valid phone number.
PROPERTY DETAILS
Security Address
Description of Property:
Intended works to Property:
Access for Valuation:
Have you or any related person, ever lived at the security address or plan to, at any time in the future?
Do you own any other buy to let properties?(please provide details in the Assets and Liabilities section)
LOAN DETAILS
Gross Loan Amount
Currency in £
Net Loan Amount
Currency in £
Estimated Value
Currency in £
Purchase Price
Currency in £
Term
Interest Deducted
Currency in £
Purpose of Loan:
Exit Strategy:
First or Second Charge:
PURCHASE
Is this a purchase below market value?
Details of the estate agent selling the property:
If this is not being purchased through an Estate Agent, please explain how you were made aware of the sale:
Is this property currently tenanted?And will it remain tenanted on completion of the purchase?Please provide rental figures if known:
Please confirm the amount of funds you have available for Deposit and/or property improvements, and where the funds have come from:
REFINANCE
Please provide details of the charges that are being repaid,company name and current loan amount:
If we are refinancing a bridging loan, please confirm the original exit strategy:
If we are refinancing a bridging loan, please confirm why the original exit strategy failed:
Is this property currently tenanted? And will it remain tenanted on completion of the refinance?Please provide rental figures if known:
APPLICANTS DETAILS
Will the loan be in a company name?
If yes, please provide name of company & company number:
Title
Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Nationality
Relationship to Other Applicant:
Marital Status:
Dependants:
Home Tel: No.
Please enter a valid phone number.
Work Tel. No:
Please enter a valid phone number.
Mobile No.
Please enter a valid phone number.
Email Address
example@example.com
Current Residential Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Time at Address:(If less than 3 years please provide 3 years address history in additional information)
Tenant/Owner:
Value of Property
Currency in £
Outstanding Charges
Currency in £
Current Lender:
Are all payments up to date

YesNo
BANK ACCOUNT DETAILS:
Bank Name and Address
Account Name
Account Number
Sort Code
Length of Time Account Held:
Employment Details
Status:(Employed/Self Employed)
Name of Business:
Job Title & Occupation Type
Address of Business:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone Number:
Please enter a valid phone number.
Time in company:
Annual Income
Currency in £

Self Employed(last 3 years Net Profit)

	Year	Net Profit
Service Quality
Cleanliness
Responsiveness

Accountants Name & Address
Accountants Tel No:
Please enter a valid phone number.
Accountants Email:
example@example.com
How long has your accountant acted for you?
References

If you do not have an accountant, please provide details of your employer or someone in authority who we may contact to confirm your identity:
Name and Address
Relationship to Borrower
Email
example@example.com
Phone Number
Please enter a valid phone number.
SOLICITOR DETAILS
Form Name and Address
Registered Number
Please enter a valid phone number.
Name of Solicitor Acting:
Telephone Number:
Please enter a valid phone number.
Email
example@example.com
CREDIT HISTORY:
Have you ever been refused a mortgage on the property to be mortgaged or, any other property?

YesNo
Have you ever had a judgement for debt recorded against you/ and or your company?

YesNo
Have you ever been bankrupt?

YesNo
Have you ever been in arrears with a mortgage, rent or loan agreements?

YesNo
Have you made a claim to the DWP in the past 12 months?

YesNo
Have you ever been convicted or charged with any offence other than a minor driving offence?

YesNo
To your knowledge have you ever been under investigation by the Police or are aware of any impending investigations against you?

YesNo
Details:
GUIDANCE FOR COMPLETION OF STATEMENT OF ASSETS AND LIABILITIES FORM

EXAMPLE OF TYPES OF ASSETS
- Cash/Savings/Deposits
- Property & Land (both residential & commercial)
- Life Policies (indicate surrender values)
- Stocks & Shares
- Cars/Vehicles
EXAMPLE OF LIABILITIES
- Mortgage – First, Second & Subsequent
- Overdrafts
- Credit Cards
- Personal Loans – Hire Purchase Agreements
IF THE CUSTOMERS ASSETS AND/OR LIABILITIES EXCEED THE NUMBER BELOW PLEASE COMPLETE A SECONDASSETS & LIABILITIES FORM.

STATEMENT OF ASSETS AND LIABILITIES*

ASSETS (*for examples see notes above)

	Details of Asset (if property, also give address)	Owners	If Mortgaged give full details (see below)	Estimated Value
1
2
3
4

Liabilities

	Type of Liability	Name Address & Reference of Creditor	If Yes, give asset(s) no. (see above)	Terms of Repayment	Amount Outstanding
1
2
3
4

ADDITIONAL INFORMATION
Signature

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INTRODUCER DETAILS

PROPERTY DETAILS

LOAN DETAILS

PURCHASE

REFINANCE

APPLICANTS DETAILS

BANK ACCOUNT DETAILS:

Employment Details

References

SOLICITOR DETAILS

CREDIT HISTORY: