Dean St - Application Form

1 » Requirements Summary/What are you trying to achieve?

Date :

Please tell us about your requirements for this mortgage.

2 » APPLICANT(S)

First Applicant name :		Date of Birth (DD/MM/YY) :

Single Married Separated Divorced
Maiden Name:		Country of Birth :

Number of Dependants		Email :

Tel :	Fax :

Current Address :		Postcode :
If less than 3 years please give previous address(es) & postcode(s) :		Actual time at address : Nature of residency :
Previous Address :		Postcode :
		Actual time at previous address : Nature of residency :

Second Applicant name :		Date of Birth (DD/MM/YY) :

Single Married Separated Divorced
Maiden Name:		Country of Birth :

Number of Dependants		Email :

Tel :	Fax :

Current Address :		Postcode :
If less than 3 years please give previous address(es) & postcode(s) :		Actual time at address : Nature of residency :
Previous Address :		Postcode :
		Actual time at previous address : Nature of residency :

3 » LOAN REQUIRED AND PURPOSE

Are clients First Time Buyers? Yes No

Purchase Remortgage Purpose of remortgage

Full status Self-certification
Is this to be : Interest Only Repayment
Residential Buy to Let Let to Buy Right to Buy Portfolio

Loan required £ :	Price / Valuation :	LTV % :	Term years :

Property to be mortgaged (if known):

House Flat

If a Flat, please state : Purpose built: Converted Ex-council Above shop

Freehold Leasehold Remaining lease in years

4 » EXISTING MORTGAGE or RENT

5 » INCOME

Applicant One

Applicant Two

Occupation :

Status :	Employed Self-employed	Employed Self-employed

Employers name / Company name
Length of employment :	years months	years months
If less than 12 months please give previous employment details:
Prev Employers name / Co name

Percentage shareholding :

Basic income £ :	per annum	per annum

Other income - guaranteed/regular :	per annum	per annum

7 » CREDIT INFORMATION

Bank Account Number	Sort Code	How long held bank account?
		years

Current / Past arrears :	Current / Past CCJ's :	Defaults or other adverse data :
Yes No	Yes No	Yes No

If YES to any of the above, please provide full information in the Case Summary above.

8 » DECLARATION - credit reference authority

I have read and accept the above declaration. Date :

YOUR HOME MAY BE REPOSSESSED IF YOU DO NOT KEEP UP REPAYMENTS ON YOUR MORTGAGE