Personal Details: Name
Date of Birth
Partners Name
Partners Date of Birth
Number of children
Contact Details: E-mail address
Please confirm email address
Telephone Number (home)
Telephone Number (work / mobile)
Address
Employment Details: Occupation / Job title
Basic Pay (before tax)
Overtime (before tax)
Bonus (before tax)
How long have you worked in this job?
Your Partners Employment Details: Your Partners Occupation / Job title
Your partners basic pay (before tax)
Your partners overtime (before tax)
Your partners bonus (before tax)
How long has your partner worked in this job?
Mortgage Details: Mortgage Balance
What bank is your mortgage with?
In what year did you buy the house?
Loan Balances
Credit card balances
How much would you like to borrow?
What term would you like the mortgage over? e.g. 15, 20, 25, 30 years etc
What is the approx. value of your home?
Please give details on your mortgage / loan arrears i.e. how may payments are you behind now, and what was the maximum number of months you've ever been behind.

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