Applicant 1	Applicant 2
	Occupation
	Basic Income P.A.
	Bonus P.A.
	Overtime P.A.
	Other Income P.A. Not state benefits
	No. of years in current employment

Do you wish to self certify          Yes  No                         Yes  No 
your income?        

Do you have an accountant ?    Yes  No                          Yes  No

Financial commitments

 

		Applicant 1	Applicant 2
	Do you have any other  loans	Yes  No	Yes  No

Do you have any Credit / Store cards

Yes  No

Yes  No

 

Credit history

		Applicant 1	Applicant 2
	Have you ever had any CCJ's ?	Yes  No	Yes  No

Have you ever Defaulted on a credit card or loan ?

Yes  No

Yes  No

Have you had mortgage arrears  in the last 12 months ?

Yes  No

Yes  No

Have you  had rent arrears in the last 12 months ?

Yes  No

Yes  No

Have you ever been Bankrupt ?

Yes  No

Yes  No

 

Have you ever had an IVA ?

Yes  No

Yes  No

Have you had a property repossessed in the last 6 years

Yes  No

Yes  No

   Remortgage Details        
                  

	Original Purchase Price	£
	Current mortgage amount	£
	Reortgage amount required	£

	Property value now	£
	% share	%
	Have you asked your Housing Association for approval to remortgage yet ?	Yes  No
	Rent charged on share not buying	£ per month

 

Repayment type

Repayment                Interest only

Term required

Years

 

	Name of Housing Association
	Tel number

 

	I would be interested in the following mortgage type
	Lowest start rate
	Fixed rate
	Discount rate
	Lowest overall rate
	No redemption penalties
	No extended tie in
	No preference

 

	Please let us have any further information that you  feel may help us with your application in the box below

 

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Think carefully before securing other debts against your home.
Your home may be repossessed if you do not keep up repayments on your mortgage