Online DIP

 
Broker Details
  Company Name: Contact:
FSA Number:
  Telephone: Fax:
Email:
Loan Details
Lender (if known):
Purchase: Remortgage:

Residential: Buy-to-Let : Let-to-Buy:

Purchase Price: Advance Required: Term:
Valuation:          Repayment: Interest Only:
Source of Deposit:
Self-Cert Required: Is the property a flat/maisonette:
Number of floors (if applicable):
Is the property of NON STANDARD construction (i.e timber framed/steel framed/concrete etc):
Ex Local Authority
Property type (i.e semi, detached, flat, bungalow or terrace):
Personal Details
Applicant 1
Applicant 2
Full Name (inc middle name):
Date of Birth:
Marital Status:
Number of Dependants:
Nationality:
First Time Buyer:
Maiden name (if applicable):
Home address (3 year history required):
 
 
 
 
Postcode:
 
 
Owner
Private Rental:
Corporate Rental:
Owner:
Private Rental:
Corporate Rental
Time at address:
Previous address:
 
 
 
 
Postcode:
 
 

Owner
Private Rental:
Corporate Rental:
:
 

Owner:
Private Rental:
Corporate Rental:

At address from:
to
to
Mortgage / rent arrears
Applicant 1
Applicant 2
Current Loan (if applicable):
Current Lender:
Total payments missed in the last 12 months:
Total payments missed in the last 6 months:
Total payments missed in the last 3 months:
Housing benefit received in the last 6 months:
Income
Applicant 1
Applicant 2
Employed:
Yes If answer is yes then answer questions below
Yes If answer is yes then answer questions below
Occupation:
Time position held:
Basic income: £
Overtime/Bonus:
Self Employed Income
Applicant 1
Applicant 2
Self Employed:
Yes If answer is yes then answer questions below
Yes If answer is yes then answer questions below
Three years accounts available:
Time Trading :
Years Months
Years Months
Chartered/Certified:
Yes No
Yes No
Net profit: £
Outstanding Debts (Applicant 1 )
Outstanding Debts (Applicant 2)
Purpose (e.g. Loan, Credit Card, HP) Monthly Payment To be redeemed
£
£
£
£
Purpose (e.g. Loan, Credit Card, HP) Monthly Payment To be redeemed
£
£
£
£
Adverse Credit (Applicant 1)
Adverse Credit (Applicant 2)
Please give details of defaults, CCJ's bankruptcy, IVA etc:
Please give details of defaults, CCJ's bankruptcy, IVA etc:
Additional Information
Is there anything further that may effect the application? E.g flat above commercial premises:

Confirmation Required. I/We (The Introducer), by ticking this box, confirm that the client(s) are aware of the terms of the application and, specifically, have given permission for credit searches to be carried out. I/We also confirm that I/We are fully aware of my/our obligations under the Data Protection Act and the potential penalities for completing this declaration without the client(s) consent. Please be advised that if you are in any doubt of your obligations regarding this issue under the Data Protection Act, DO NOT CONTINUE ANY FURTHER, DO NOT TICK THIS BOX and contact Bluebell Mortgage Packaging for clarification. Bluebell Mortgage Packaging will be unable to accept any request to carry our credit searches to perform any further action in connection with establishing the availability of finance for the client(s) unless this
By clicking submit you are agreeing to the above terms.

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