First Name
*
Last Name
*
Email
*
What are you looking to do ?
*
Buy a Property
Remortgage/Refinance
Investment Commercial lending
Personal insurance
Business Insurnace
Other
How will the property be used?
*
Live there
Rent it out
Other
Rented - expected/ current rent
Do you have a deposit?
*
Yes
No
Saving For One
How much deposit do you have?
*
Are you a first time buyer?
*
Yes
No
How would you rate your credit?
*
Poor
Fair
Good
Excellent
What is the (estimated) property value?
*
What mortgage amount do you require?
*
How soon are you looking to proceed?
*
ASAP
1 to 3 months
4 to 6 months
7 to 12 months
12 months plus
Date of birth
*
Number Of Dependants
*
Marital Status
*
Married
Single
Divorced
Seperated
Widowed
Cohabit
Civil Partnership
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Employment Type
*
Employed
Sole Trader
Partnership
Limited Company Business owner
Retired
Not in employment
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Income approximately
*
Employment Start Date
*
• Do you hold a UK passport? If not, please detail your visa situation
*
Smoked or used any tobacco or nicotine replacement products in the last 12 months?
Yes
No
Any other relevant information
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