Equity Release
Mortgage
CONFIDENTIAL ENQUIRY
Please Complete all Sections
Contact
Details
Full Name
Address
Postcode
Email Address
Home Tel
(Required) - We cannot process your
application if you do not provide a contact telephone number.
Work Tel
(optional)
Mobile
Marital Status
Single
Married
Divorced
Separated
Co-Habiting
Widowed
Is this a single, or joint application?
Single
Joint
Partner's full name
(if joint application)
Employment Details
What is your employment status?
Employed
Self Employed
Unemployed
Retired
Your partner's employment status?
(if joint application)
Not Applicable
Employed
Self Employed
Unemployed
What is your gross annual income?
£
Your partner's gross annual income?
(if joint application)
£
The Property and Mortgage Details
How much would you say your home is worth?
(approx)
£
If you already have a mortgage, what is your current mortgage balance?
(approx)
£
How much are you paying for your current mortgage?
(if applicable)
£
per month
How much capital would you like to raise by releasing the equity?
£
Brief Credit History
Have you had any CCJ's, Decrees or Defaults in the past 6 years?
Yes
No
(Remember, we can still source mortgages for people with bad credit, so having CCJ's will not affect your application)
Helpful Information and Comments
To submit this information
Your home is at risk if you do not keep up the repayments on a mortgage or other loans secured on it.
