Mortgage quotation form

Applying for a quotation for a Mortgage / Remortgage?
Please help us by filling in the details below. If you’d rather, call us on: 01834 813 696

By completing this enquiry from, you are agreeing us to using the information provided in order to give you an indication of costs. This form is merely intended to allow us to give you an indication based on the information you supply. We will undertake an appropriate fact find and give individual advice before any arrangements are entered into unless you indicate that you wish to deal on an “execution only” basis.

“Any information you provide to us with will be used solely by us in order to enable us to respond to your enquiry and to for the basis of any records we maintain while you are our client. Information will not be shared with any third party except to enable us to provide an indicative illustration.

Keyfacts: About our Mortgage services

Applicant 1 Applicant 2   Title: Mr Mrs Miss Ms ---- Mr Mrs Miss Ms   Name:   Date of Birth:   Do you smoke? Yes No ---- Yes No   Have you had any credit issues eg CCJ or arrears? Yes No ---- Yes No   Income:   Any other comments:       Telephone:   Mobile:   Email:   Is there a best time to call:   Postal Address:   Post Code:   If you’re looking for a new mortgage or a remortgage please tell us:   Type of Rate: Capped Fixed Cashback Discount Flexible Tracker Dont Know   The price of the new property:   The mortgage amount you’d like:   How many years would you like the mortgage to last?:   Would you prefer a repayment or interest-only mortgage?: Repayment Interest-only   Are you a first-time buyer? Yes No   If you’re not a first time buyer, indicate the cost of moving your mortgage if you’re aware of one:   Have you found the property? Yes No   Have you sold your existing property?: Yes No   Would you like details of Buildings & Contents Insurance?: Yes No   Can we provide details of Mortgage Payment Protection? Yes No   Do you require a life or critical illness quotation from one of our independent financial advisors? Yes No   If you're remortgaging please tell us in addition:   How much extra capital you’re looking for:   Who provides your current mortgage?:   How much do you pay per month?:         Confirm requested: this form is being submitted to request a quotation or requested a callback to discuss requirements. Yes No   I/We have read the Initial Disclosure document . Yes No If not, click here to view the Initial Disclosure document.