Please select Mr Mrs Miss
Ms Dr Prof Rev
First name: Enter name eg. John *
Family name: Enter surname eg. Smith *
Date of birth: Select DoB *
1st 2nd 3rd 4th 5th 6th 7th 8th
9th 10th 11th 12th 13th 14th 15th 16th
17th 18th 19th 20th 21st 22nd 23rd 24th
25th 26th 27th 28th 29th 30th 31st
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Please enter your current address: Enter address *
Postcode: Enter Postcode eg. AB1 2CD *
Daytime phone number: *
Evening phone number: *
Mobile phone number: We require ANY two phone numbers *
Best time to call: Select time of day
Morning ( 9am - Noon ) Afternoon ( Noon - 6pm ) Evening ( 6pm - 9pm )
Email address: Enter email eg. firstname.lastname@example.org *
Do you want to: Select the mortgage type you require - purchase, remortgage, or buy-to-let *
Buy a property?
Remortgage a property?
Buy a property to let?
Have you found a property? Select yes or no * Yes No
Are you a first time buyer? Select yes or no * Yes No
In which country? Select country * Please Select
Andorra Australia Bahamas
Barbados Belize Bulgaria
British Virgin Islands Cayman Islands Cyprus
Canada Dutch Antilles France
Greece Ireland Italy
Jamaica Malta Mexico
New Zealand Poland Portugal
Spain St. Lucia Switzerland
Trinidad & Tobago Turks & Caicos USA
Do you need to self certify your income? Select yes or no * Yes No
What is the estimated value of the property? Enter property value, eg. 120,000 *
How much would you like to borrow? Enter mortgage size, eg. 100,000 * The amount you want to borrow is more than % of the value of the property value. You can borrow up to £ on a property of this value, and you will require a deposit of at least £ .
How soon do you need your mortgage? Select number of months
Please select 1 month 2 months 3 months
How long do you need the mortgage for? Select number of years
Please select 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years 13 years 14 years 15 years 16 years 17 years 18 years 19 years 20 years 21 years 22 years 23 years 24 years 25 years 30 years 40 years 50 years
Please use this space to tell us the best time to call you and any other info you may wish to add:
Yes, I am actively seeking a mortgage and would like to discuss my needs with a mortgage consultant who will contact me by telephone.
Unfortunatly we cannot find a suitable broker for mortgages of this type. Please submit to contine to a popular list of other mortgages providers who may be able to help.
Based on your mortgage requirements we have selected the FSA regulated broker "
" to help you with your enquiry. Please click submit to confirm that you are happy for them to contact you by telephone. Due to your borrowing requirements being lower than our minimum for a mortgage, we suggest a secured loan from the FSA regulated broker "
". Please click submit to confirm that you are happy for them to contact you by telephone.
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Personal information will be treated as confidential by us and held in accordance with the Data Protection Act 1998.
You agree that such personal information may be used to provide you with details of services and products in writing, by e-mail, or by telephone.