Online Application – The Mortgage Clinic
First Applicant
Second Applicant
*Name
*Name
*Surname
*Surname
*Date of Birth
*Date of Birth
*Current Address
*Current Address
Postcode
Postcode
*How long at this address?
*How long at this address?
*Telephone (home)
*Telephone (home)
Telephone (work)
Telephone (work)
Telephone (mobile)
Telephone (mobile)
E-mail
E-mail
*REQUIRED
*REQUIRED
What is your position?
What type of Mortgage do you require?
Variable
Fixed
Discount
Capped
Cash Back
Flexible
New property details
Purchase price £
Loan required £
Deposit/Equity £
Term years
Existing property details
Existing mortgage
Selling Price
Present Lender
Existing Monthly Payment
If purchase, is the deposit coming from your own resources without additional borrowing?
yes
no
If NO, please provide full details
Is the property leasehold?
yes
no
If yes, how many years remaining?
Bank Details
Do you have a bank account?
first applicant
second applicant
yes
yes
no
no
sort code
Financial Details
Other Borrowing:
Please provide details of all Personal Loans/Credit Cards/Hire Purchase/Maintenance Payments etc.
Balance Outstanding?
Monthly Payment?
To continue during mortgage?
Expiry date?
Yes
No
Financial History
First Applicant
Second Applicant
Have you ever been bankrupt?
Yes
No
Yes
No
Have you ever had any arrears?
Yes
No
Yes
No
Have you ever had any county court
Yes
judgements?
No
Yes
No
Have you ever had a default?
No
Yes
No
Yes
If you have answered Yes to any of
the above, please provide full details
Employment Details
First Applicant
Second Applicant
Permanent Temporary Contract
Permanent Temporary Contract
Occupation?
Length of Employment?
Is the position . . . .
Gross basic income
Guaranteed Allowances
Guaranteed Overtime/Bonuses
Regular
Overtime/Commission
Total
Self Employed Details
First Applicant
Type of Business?
Second Applicant
Are there 3 year accounts? Yes
No
Yes
No
Net Profit for year 200Net Profit for year 200Net Profit for year 200-
If Re-mortgage or Right to
Buy, please state purpose
of the loan
Declaration
I confirm that the details I have given are accurate to the best of my knowledge and can be used to source a
mortgage on my behalf.
Reset
Submit