Mortgage Planner Enquiry

	Applicant 1	Applicant 2
Title: *
First Name or Initials: *
Surname: *
Date of Birth: (dd/mm/yy) *
Address: *
Town/City: *
Postcode: *
Length of time at above address: *	years	years
Email: *
Tel No: *
Mobile Tel No:
Marital Status: *
Do you require a Self Certification Mortgage? *	yes no unsure	yes no unsure
Residential Status: *
Do you require a repayment or interest only mortgage?	yes no unsure
When are you planning to take out this mortgage?
Please select your preferred mortgage type
What is your current employment status? *
Gross annual earning *	£	£
Other income per annum	£	£
Loans/credit cards outstanding (excluding current mortgage if to be cleared)	£	£
Monthly repayments on the above	£	£
Reasons for enquiry? *
Purchase price/ approx value of property? *
Mortgage amount & type *
What term (e.g. 25 years) and preferred rate? (eg, fixed, variable) *	years
Existing mortage lender (if any)
Other information or comments... eg arrears, ccj's, guarantors etc