Independent Mortgage Advice from UK FSA regulated brokers

Name
Address
Day Time Phone
Home Phone
Email
Applicant 1 (date of birth)
Applicant 1 Smoker ?
Name Applicant 2
Applicant 2 Smoker ?
Applicant 2 (date of birth)
Mortgage/remortgage
Mortgage Amount required £
Valuation/purchase price £
Term	Years
Applicant 1 Employed/self employed
Applicant 2 Employed/self employed
If any Applicant is self employed please state how long self employed and the net profits for the last 3 years with corresponding dates
Existing Mortgage lender
Salary Applicant 1 £
How many years/months at current employment?
Salary Applicant 2 £
How many years/months at current employment?
Do you have any other loans /credit.
If yes, please enter how much per month is payable on them, and remaining months until finished, (unless they are to be cleared from the remortgage money or other funds, in which case, type in "will be cleared" immediately after those loans that this applies to)
Type of Mortgage required if known :
Repayment method, if known:
Do you have any adverse Credit i.e. loan defaults, ccj's
or past problems with: Credit/County Court Judgements IVAs/Bankrupt
If yes to either of the above two questions, please give details below. In the case of a ccj, please state the number and value of the ccjs, and the number of months since satisfied. If not satisfied ..say so.
Any other relevant information, i.e. are you interested in a specific lenders product or are there any special circumstances we should be aware of?

Independent Mortgage Advice