Section 1. Applicants personal and contact information

1. Contact details

Applicant 1 / Applicant 2
Surname:
Forenames:
Title:
Maiden name / previous name:
Mobile number:
E-mail address:
Home telephone:
Home fax:
Work telephone:
Work fax:
Current residential address:
Postcode: / Postcode:
Date moved to current address:
PREVIOUS ADDRESS HISTORY
(If under 3 years at current address)
From: / Until: / From: / Until:

2. Personal details

Applicant 1 / Applicant 2
Date of birth:
Marital status:
Dependents: / Number: / Age: / Number: / Age:
Expected retirement age:
Nationality:
Permanent UK residential rights: / Yes: / No: / Yes: / No:
How long have you had UK residency: / Years: / Years:
Residential status: / Owner: / Tenant: / Owner: / Tenant:
Other: / If other please detail in notes / Other: / If other please detail in notes
Are you on the electoral role: / Yes: / No: / Yes: / No:

Section 2. Applicants financial information

3. Employment details

/ If self-employed, please fill out sections 6 and 7.
Applicant 1 / Applicant 2
Employed or Self-employed:
National Insurance Number:
Occupation:
Nature of business:
Name of Business:
Business address:
Postcode: / Postcode:
Date started:
Contract / probation period if any:
Previous employer if under 3 years:
Previous employment dates: / From: / Until: / From: / Until:
Basic income per annum:
Overtime / bonus per annum:

4. Self-employment

Applicant 1 / Applicant 2
How many years accounts available: / Number of years: / Number of years:
Net profit last year:
Previous year 1:
Previous year 2:

5. Personal details

Have you ever had any arrears, a loan or mortgage refused or a default judgement registered against you?
Applicant 1 / Applicant 2
Mortgage arrears: / No: / Yes: / Months: / No: / Yes: / Months:
A loan or mortgage refused: / No: / Yes: / No: / Yes:
Loan default: / No: / Yes: / Number: / No: / Yes: / Number:
CCJ’s: / No: / Yes: / Number: / No: / Yes: / Number:
Have you ever been declared bankrupt or made arrangements with your creditors?
No: / Yes: / No: / Yes:

6. Commitments

/ Current commitments: credit cards, personal loans, hire purchase, bank loans etc
App 1/2 or joint / Company name / Commitment type / Account number / End date / Amount outstanding / Monthly repayments / Redeemed prior to or on completion? / Secured loan

7. Current mortgage details

/ Your Main Residence
Lender details / Applicant 1 / Applicant 2
Name of Lender:
Mortgage account number:
Date mortgage taken out:
Mortgage term remaining: / Years: / Years:
Previous lender if less than 2 years:
Will this mortgage be redeemed on completion of the new mortgage?
No: / Yes: / No: / Yes:
Has this mortgage or tenancy been DSS assisted within the last 12 months?
No: / Yes: / No: / Yes:
Have you previously owned a property?
No: / Yes: / No: / Yes:
Have you any other mortgage, currently own or part own any other property?
Please give details in section 12. / No: / Yes: / No: / Yes:
Mortgage details
Amount of mortgage outstanding:
Monthly repayments:
Mortgage payments are: / Int Only / Capital & Interest / Int Only / Capital & Interest
Property details
Original date of purchase:
Original purchase price:
Current property value:

8. Current tenancy details

Applicant 1 / Applicant 2
Landlords name:
Landlords address:
Postcode: / Postcode:
Amount of rent paid per month:

9. Property portfolio summary

/ Details of any other properties in your portfolio, including properties abroad.
No. / Address / Postcode / Estimated value / Mortgage amount / Mortgage p.m. / Rent p.m.
1
2
3
4
5
6
7
8
9
10

Section 3. New mortgage request

10. Property to be mortgaged

Address of property to be mortgaged:
Postcode:
Property description
Type of property: / Year built: / No. of bedrooms:
Description of property:
Ex-local authority: / Yes: / No:
Standard Construction: / Yes: / No:
Commercial, Next to or Above: / Yes: / No:
Financial details:
Estimated value if applicable:
Any discount deal:
Purchase price: / Any time constraints:
Deposit: / Source of deposit:
How much do you want to borrow: / Over what term:
On which basis do you require the borrowing: / Int Only: / Capital & Interest:
Purpose of loan
Residential (own home) mortgage: / Buy-To-Let Mortgage: / Bridging Finance:
Mortgage type: / Purchase: / Re-Mortgage:
Tenure details
Tenure of property / Years left on lease:
Is the property immediately lettable: / Yes: / No: / Type of tenants:
Rental income: / Rental value:
Access for valuer
Contact name: / Telephone number:
Is the property immediately lettable: / Yes: / No:

DMI Finance 5

11. Additional services
Changes in personal circumstances, such as loss of income, can lead to you being unable to repay
all or part of your mortgage commitments. Would you like us to call you to discuss payment protection insurance? / Yes: / No:
We can offer competitive quotes on buildings insurance on all properties in the UK and Abroad. Would you like us to call you to discuss these services? / Yes: / No:
We have access to a nationwide network of solicitors who can offer the most competitive rates for conveyancing work. Would you like us to discuss these services with you? / Yes: / No:

12. Additional notes

DMI Finance 5