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Tracker Rate
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Discounted Rate
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Second Charge
Intermediary Enquiry Form
Please enable JavaScript in your browser to complete this form.
1
Product
2
Limited Company / LLP / Trust
3
3a. Applicant 1 Details
4
3b. Applicant 2 Details
5
4a. Applicant 1 Monthly Expenses
6
4b. Applicant 2 Monthly Expenses
7
Security Details
8
Synopsis
9
Digital Signature
Borrower type
*
Borrower Type
UK Resident
UK Company
Non UK Resident
Non UK Company
Estimated completion date
*
Required loan amount
Purpose of loan
*
Purchase the security
Purchase the security
Purchase another property
Debt consolidation
Home improvements
Capital raise - Business purpose
Re-mortgage - no extra case raised
Transfer of equity
Purchase and develop
Capital raise to develop
Other
Required term
Required term
Repayment type
*
Serviced
Serviced
Retained
Part & Part
Interest Only
Capital and Interest
Next
Company name
*
Company number
*
Number of Directors
Comporate entity type
SPV
SPV
Trading Company
UK Incorporate?
Yes
Yes
No
Sector
Next
Title
Mr.
Mr.
Mrs.
Miss.
Ms.
Dr.
Sir.
Lord.
Lady.
Employment
Employed
Employed
Self-Employed
Retired
Unemployed
First Name
*
Monthly earnings after tax
Surname
*
Maintenance pcm
DOB
Dividend pcm
Nationality
Tax Credits pcm
Address
Private Pension pcm
State Pension pcm
Date move in
Child Benefit pcm
Residency status
Owned
Owned
Rented
Living with Family
Housing Association
Council
Other Income pcm
Provide details in notes section.
Advertise credit (last 6 years)
Net Worth
Has had BBLs / CBILs?
Yes
Yes
No
Anticipated retirement age
Next
Title
Mr.
Mr.
Mrs.
Miss.
Ms.
Dr.
Sir.
Lord.
Lady.
Employment
Employed
Employed
Self-Employed
Retired
Unemployed
First Name
*
Monthly earnings after tax
Surname
*
Maintenance pcm
DOB
Dividend pcm
Nationality
Tax Credits pcm
Address
Private Pension pcm
State Pension pcm
Date move in
Child Benefit pcm
Residency status
Owned
Owned
Rented
Living with Family
Housing Association
Council
Other Income pcm
Provide details in notes section.
Advertise credit (last 6 years)
Net Worth
Has had BBLs / CBILs?
Yes
Yes
No
Anticipated retirement age
Next
Buildings & Contents Insurance
Communicating (Phone, wifi, TV etc..)
Ground rent / service charge
Clothing
Council Tax
Recreation
Gas / electric / fuel
Pension
Water
Life Insurance
Maintenance / Child Support
Household goods / services
Shopping (food, drink etc...)
Memberships / subscriptions
Transport (fares, petrol, tax)
Savings / investments
School Fees
Other
Childcare
Credit Commitments
(If more than 3 please use notes in Synopsis section.)
Type of credit
Type of credit
Mortgage
Mortgage
Credit / Store Cards
Loan / HP / Lease
Payday Loans
Type of credit
Mortgage
Mortgage
Credit / Store Cards
Loan / HP / Lease
Payday Loans
Type of credit
Mortgage
Mortgage
Credit / Store Cards
Loan / HP / Lease
Payday Loans
Remaining Term
Remaining Term
Remaining Term
Remaining Term
Balance outstanding
Balance outstanding
Balance outstanding
Balance outstanding
Monthly payment
Monthly payment
Monthly payment
Monthly payment
Next
Buildings & Contents Insurance
Communicating (Phone, wifi, TV etc..)
Ground rent / service charge
Clothing
Council Tax
Recreation
Gas / electric / fuel
Pension
Water
Life Insurance
Maintenance / Child Support
Household goods / services
Shopping (food, drink etc...)
Memberships / subscriptions
Transport (fares, petrol, tax)
Savings / investments
School Fees
Other
Childcare
Credit Commitments
(If more than 3 please use notes in Synopsis section.)
Type of credit
Type of credit
Mortgage
Mortgage
Credit / Store Cards
Loan / HP / Lease
Payday Loans
Type of credit
Mortgage
Mortgage
Credit / Store Cards
Loan / HP / Lease
Payday Loans
Type of credit
Mortgage
Mortgage
Credit / Store Cards
Loan / HP / Lease
Payday Loans
Remaining Term
Remaining Term
Remaining Term
Remaining Term
Balance outstanding
Balance outstanding
Balance outstanding
Balance outstanding
Monthly payment
Monthly payment
Monthly payment
Monthly payment
Next
Address
Tenure
Freehold
Freehold
Leasehold
Feuhold
Property type
Residential
Residential
Semi Commercial
Commercial
Land
Remaining years
Sub category property type
B&B
B&B
Business Center
Buy to Let
Care Home
Car Showroom
Car Park
Casino
Castle
Children Nursery
Conversion
Development
Development/Conversion
Equestrain
Ex LA Property
Factory
Farm/Agricultural
Farm/Equestrain
Flat
Flat (above 6th Floor) - Ex Local Authority
Flat (above 6th Floor) - Above/Adj Commercial
Flat (below 6th Floor) - Ex Local Authority
Flat (below 6th Floor) - Above/Adj Commercial
Flat above commercial - Ex Local Authority
Flat above commercial - Above/Adj Commercial
Freehold Block of flats
Garden Center
Grade 1 Listed Building
Grade 2 Listed Building
Guest House
Guest House (inc living accom)
House - Single Dwelling - Ex Local Authority
House - Single Dwelling - Above/Adj Commercial
HMO
HMO (7 or more rooms)
HMO/MultiLet
Holiday Let
Hotel
Industrial
Industrial East
Kennels/Cattery
Land
Land with Detailed Planning
Land without Outline Planning
Launderette
Live Work Unit more than 40% residential
Live Work Unit less than 40% residential
Maisonette
Manor House
Medical Centre
Night Club
MOT Station
Non Standard Construction Resi/BTL
Office
Petrol Station - current
Petrol Station - former
Portfolio - commercial
Portfolio - mixed
Portfolio - residential
Pub / Bar
Pub / Restaurant
Pub - close
Pub - trading
Religious Premises
Residential
Restaurant
Retain Unit
Retain Unit with living accomodation
School
Semi-Commercial
Serviced Apartment
Shared Ownership
Shopping Center
Shorts Club
Storage Unit / Look up / Garage
Takeaway
Unmortgagable property
Veterinary Practice
Warehouse
Detached House
Semi detached house
Terraced house
Detached bungalow
Semi detached bungalow
Terraced bungalow
Other
Owner occupied / investment
Owner occupied
Owner occupied
Investment
Vacant
Construction type
Standard
Standard
Non-Standard
Do you or family live (or intend to live) in 40% or more of security?
Yes
Yes
No
Estimated property value
Rent
Estimated purchase price
Period
Weekly
Weekly
Monthly
Annually
Ownership
Already Owned
Already Owned
To be Purchased
Let to
Professional Tenant
Professional Tenant
Family
DSS
Student
Commercial
Existing lender
Currently vacant?
Yes
Yes
No
Existing balance
Additional security available?
Yes
Yes
No
If yes please put property details in synopsis box below.
Charged offered
1st Charge
1st Charge
2nd Charge
1st & 2nd Charge
Property is:
New Build
Ex Local Authority?
Has Agrecultural ties / restrictions
Tick all that apply.
Next
Brief Description of the deal required for team:
Next
Signature
Clear Signature
Date / Time
Date
Time
Submit