Intermediary Details
 
  Mortgage Broker Name
  Broker Company
  Broker FSA Number
  Telephone number (including area code)
  E-mail Address
         
   
 
  Client Details
Applicant 1
  
Applicant 2
  Title
 
  First Name
 
  Middle Name(s)
 
  Surname
 
  Marital Status
 
  Date of Birth
 
  Home Telephone Number (including area code)
 
  Work Telephone Number (including area code)
 
  Mobile Telephone Number
 
  Current Address
 
  Date Moved Into Current Address
 
  Previous Address (3 year history)
 
  Credit Search*
Yes No
 
Yes No
*By checking yes to the above I confirm that the client has given authority for W&B Mortgage Solutions to carry out a formal credit search
         
   
 
  Adverse
Applicant 1
  
Applicant 2
  Arrears?
Yes No
 
Yes No
  If yes, please give details
 
  CCJs?
Yes No
 
Yes No
  If yes, please give details
 
  Bankruptcy?
Yes No
 
Yes No
  If yes, please give details
 
  IVA?
Yes No
 
Yes No
  If yes, please give details
 
  Previous Reposession?
Yes No
 
Yes No
  If yes, please give details
 
  Defaults?
Yes No
 
Yes No
  If yes, please give details
 
         
   
 
  Loan & Property
 
  Purchase Price
  Value
  Loan Required
  Repayment Method
  If 'Interest Only', please confirm repayment method
  Purchase or Remortgage
  Type of Loan
  If bridging finance please confirm exit route if known, if there is no exit route currently in place please confirm UNKNOWN
  Expected monthly rental income if BTL
     
  Standard Construction
Yes No
  Property Type
         
   
 
  Income & Commitments
Applicant 1
Applicant 2
  Employed/Self Employed
 
  If Other, please give details
  Occupation
  Business Name
  Full status/self cert
 
  Basic
 
  Bonus/Commission
  Overtime
 
  Time in current employment
 
  Mortgage or secured lender
 
  Mortgage or secured loan balance
 
  Mortgage or secured loan monthly payment
 
  Mortgage or secured lender 2
 
  Mortgage or secured loan balance 2
 
  Mortgage or secured loan monthly payment 2
 
  Mortgage or secured lender 3
 
  Mortgage or secured loan balance 3
 
  Mortgage or secured loan monthly payment 3
 
  Credit card total balances
 
  Total monthly payments on loans
         
   
 
  Additional information
         
   
 
 
 
     
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
   
 
     
 
Important Information...
W&B Mortgage Solution Ltd is authorised and regulated by the Financial Services Authority.
Registered office: The Studio, Walton House, 90 London Road, Hook, Hampshire, RG27 9LF Registered in England & Wales Reg No. 5241817
 
© W&B Mortgage Solutions Ltd, Brightwell Grange, Britwell Road, Burnham, Buckinghamshire SL1 8DF. Telephone 01628 663666 - Internet Marketing By Weblinx