Mortgage Enquiry Form
1. BROKER / INTRODUCER DETAILS
IMAP Broker Number (leave blank if not known)
FSA Number (leave blank if not applicable)
Name
Title
Forename
Surname

Company
Telephone Number
Email Address
2. LOAN DETAILS
Purpose of Loan * Purchase
Purchase - Buy To Let
Purchase - First Time Buyer
Purchase - Right to Buy
Remortgage - Home
Remortgage - Buy To Let
Amount Required * £
Purchase Price/Estimated Value * £
Property Type

House
Flat
Maisonette
Bungalow
Other
#~~|>>#

Is property Ex-Local Authority?   
3. PERSONAL DETAILS
 
Applicant 1
Applicant 2
Title *
Forename(s) *
Surname *
Maiden/Previous/Alais Names
Maiden / Previous / Alias Name(s)
Date of Birth (dd/mm/yyyy) *
Home Telephone
Work Telephone
Mobile Telephone
E-Mail

Present Address *





Present Postcode *
How long at this address? * years  months years  months
Residential status *
Previous Address
(if less than 3 years at current address)






Previous Postcode
How long at this address?
years  months
years  months
4. CREDIT HISTORY
 
Applicant 1
Applicant 2
Current Lender
Have you had any arrears with your mortgage in the last - 24 months?
12 months?
6 months?
3 months?
24 months?
12 months?
6 months?
3 months?
CCJs in last 3 years?
Yes No
Yes No
Details of Satisfied CCJs
Bankruptcy/IVA?
Yes No
Yes No
If yes please provide details
5. EMPLOYMENT DETAILS
 
Applicant 1
Applicant 2
Occupation
Type of employment Employed
Self-Employed
Retired
Unemployed
 Employed
Self-Employed
Retired
Unemployed
Self-certification of income? Yes No Yes No
Income
£
£
6. ADDITIONAL NOTES
BY CLICKING THE APPLY BUTTON, YOU AGREE TO THE FOLLOWING TERMS & CONDITIONS

I confirm that I have made the applicant(s) aware that the information given in their mortgage enquiry form will be given to a credit reference agency which will keep a record of the search, and that the information may be used by other lenders in assessing applications from the applicant(s) or other members of the applicants’ household and for debt recovery, tracing and fraud prevention.
The applicant(s) understand(s) that the details supplied may be held and made available to other companies. Under the Data Potection Act 1998, we have to inform the applicant(s) how their personal information will be used. The information provided on this form, including any sensitive personal information, may be used by ADS Mortgages and may also be shared with third parties.
The applicant(s) consents(s) to the fact that the details on this form will be passed to ADS Mortgages, PO Box 48098, London, SE28 8WR, who will make contact regarding the provision of mortgage services.