Mortgage Enquiry Form

SingleJoint

Member Number (Applicant 1)

Member Number (Applicant 2)

Full Name (Applicant 1)*

First NameLast Name

Full Name (Applicant 2)

First NameLast Name

Address (Applicant 1)*

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Address (Applicant 2)

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Marital Status (Applicant 1)*

Marital Status (Applicant 2)

Date of Birth (Applicant 1)*

Date

Date of Birth (Applicant 2)

Date

Number of years resident in Ireland (Applicant 1)*

Number of years resident in Ireland (Applicant 2)

Number of dependent children (Applicant 1)

Dependent children's dates of birth (Applicant 1)

Number of dependent children (Applicant 2)

Dependent children's dates of birth (Applicant 2)

YesNo

Is the existing mortgage in arrears, or ever been restructured or had part of the mortgage parked on a split facility? If so, give details.

Employment Status (Applicant 1)*

Employment Status (Applicant 2)

Name of Employer (Applicant 1)

Name of Employer (Applicant 2)

How long in this employment? (Applicant 1)

How long in this employment? (Applicant 2)

YesNo

Gross annual salary (Applicant 1) (€)*

Gross annual salary (Applicant 2) (€)

Net monthly salary (Applicant 1) (€)*

Net monthly salary (Applicant 2) (€)

Any additional income? (Applicant 1)

Source of additional income (Applicant 1)

Any additional income? (Applicant 2)

Source of additional income (Applicant 2)

Amount of mortgage requested (€) (Applicant 1)*

Amount of mortgage requested (€) (Applicant 2)

Term of mortgage required (years)*

Purchase price/value of property (€)*

BER rating of the property

Amount & source of deposit (Savings/Equity/Gift). Indicate how much for each:*

Monthly outgoings (Mortgage/Rent/Loans/Credit Card/Hire Purchase/PCP only). Confirm type and repayment:*

Contact number*

Please enter a valid phone number.

Email address*

example@example.com

Signature (Applicant 1)*

Date (Applicant 1)*

Date

Signature (Applicant 2)

Date (Applicant 2)

Date

Warning: If you do not meet the repayments on your credit agreement, your account will go into arrears. This may affect your credit rating, which may limit your ability to access credit in the future.

Warning: Your home is at risk if you do not keep up repayments on a Mortgage Loan or any other loan secured on it.

Warning: The payment rates on this Mortgage Loan may be adjusted by the Credit Union from time to time.

Warning: The cost of your monthly repayments may increase.

Warning: This new loan may take longer to pay off than your previous loans. This means you pay more than if you paid over a shorter term.

Notice: Under the Credit Reporting Act 2013 lenders are required to provide personal and credit information for credit applications and credit agreements of €500 and above to the Central Credit Register. This information will be held on the Central Credit Register and may be used by other lenders when making decisions on your credit application and credit agreements.

The Central Credit Register is owned and operated by the Central Bank of Ireland. For more information see www.centralcreditregister.ie

Mortgage Enquiry Form

Applicant Details

Property & Mortgage Details

Contact Information

Warnings and Notices