Debt Management
Mortgages Loans

We appreciate that the form opposite appears daunting by looking at it, however not all information is required to be inputted to receive a quote.

Please fill it in as best as you can and we will conduct your quote around this.

If you prefer, please click the link below to contact a mortgage advisor.


Mortgage Quotation Tue/06/19


About you
*Your Situation:
  First Applicant Second Applicant
First Name:
Middle Name:
Maiden Name
(if appropriate):
Date of Birth:
House Number/Name:
Address 1:
Post Code:
When did you move into this address:
Please provide details of previous address history covering last 3 years:
* Daytime Telephone Number:
Evening Telephone Number:
Mobile Telephone Number:

* Email Address:

Your income
Length of Employment:
Is the Position:
Gross Basic Income:
Guaranteed Overtime/Bonuses:
Regular Overtime/Commission:
Self Employed Details (If Applicable)
Type of Business:
Are Accounts Available:
Nett Profit for 2003:
Nett Profit for 2002:
Nett Profit for 2001:
Your Credit History
Have you ever been Bankrupt/Repossessed?
Have you ever had any County Court Judgments?:
Have you ever had any Defaults?:
Have you ever had any arrears?:
If you answered yes to any of the above please provide more details:
Your Mortgage, Loans and Credit Cards
Name of existing Mortgage Lender:
Current Mortgage Balance:
Purchase Price or Current Valuation of Property:
Mortgage or Loan Amount you Require:
Please provide details of all Personal Loans/Credit Cards/Hire Purchase/Maintenance Payments etc...
Name of Lenders
(Add further details in the comments box at the end of the form)
Combined Balance of all the above:
Average payments per month for all above:
The Mortgage you Need
Which mortgage products are you most interested in?:
Have you found a property?:
In what time scale do you require the mortgage?:
Have you or your partner recently applied for a mortgage quote elsewhere?:
Please enter any further information or comments that may be relevant to your situation:
I have read the Terms Of Business:

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Your home is at risk if you do not keep up repayments on a mortgage or other loan secured on it.
Written quotations available upon request. Licensed credit brokers.

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