Application Form

Fields marked * are required

PERSONAL INFO
First NameLast Name
Co Borrower First NameCo Borrower Last Name
Email AddressPhone Number
Borrower NationalityCo-Borrower Nationality
Marital StatusNumber of dependents, children or other
How did you hear about us?
PROPERTY DETAILS
Loan PurposeAmortization TypePurchase priceLoan Amount
Purchase locationLoan Term (Length)Renovation costPersonal Contribution
Property TypeLTVNotary fees  
OccupancyRateAgent fees  
Leaseback or Classic?Est. Closing DateTotal CostTotal Funds for purchase
EQUITY RELEASE
Current Monthly PaymentApproximate value
Year Property AquiredProperty Original Cost
ADDRESS – PROPERTY TO BE MORTGAGED
Property Street 1Property Street 2
Property CityProperty State
Property ZipProperty Country
EMPLOYMENT – BORROWER 1 + BORROWER 2 DETAILS
Employment Borrower
Borrower Employer
Borrower Title
Borrower Emp City
Borrower Yrs at Employer
Borrowers Previous Occupation if less than 2 years
Borrower Yrs in line of work
Income
Borrower Please select a base currency
If other currency, please state which
Borrower Basic Annual Income
Borrower Commissions for last 3 years
Borrower Average Bonus for last 3 years
Borrower Average Dividends for last 3 years
Borrower Pension Income
Borrower Other Income
Borrower Rental Income
Borrower Future Rental Income
Borrower TOTAL INCOME
Employment Co-borrower
Co-Borrower Employer
Co-Borrower Title
Co-Borrower Emp City
Co-Borrower Yrs at Employer
Co-Borrowers Previous Occupation if less than 2 years
Co-Borrower Yrs in line of work
Income
Co-Borrower Please select a base currency
If other currency, please state which
Co-Borrower Basic Annual Income
Co-Borrower Commissions for last 3 years
Co-Borrower Average Bonus for last 3 years
Co-Borrower Average Dividends for last 3 years
Co-Borrower Pension Income
Co-Borrower Other Income
Co-Borrower Rental Income
Co-Borrower Future Rental Income
Co-Borrower TOTAL INCOME
AMOUNT OF RENT YOU PAY
ASSETS + LIABILITIES
PROPERTY
Property 1
Address of propertyCurrent valueUse of propertyName of lender
Monthly paymentDate loan beganInitial loan amountInitial loan termOutstanding capitalRental income per month
Property 2
Address of propertyCurrent valueUse of propertyName of lender
Monthly paymentDate loan beganInitial loan amountInitial loan termOutstanding capitalRental income per month
Property 3
Address of propertyCurrent valueUse of propertyName of lender
Monthly paymentDate loan beganInitial loan amountInitial loan termOutstanding capitalRental income per month
Property 4
Address of propertyCurrent valueUse of propertyName of lender
Monthly paymentDate loan beganInitial loan amountInitial loan termOutstanding capitalRental income per month
LOANS
Loan 1
Type of loanName of lenderMonthly payment
Date loan beganInitial loan amountInitial loan termOutstanding balance
Loan 2
Type of loanName of lenderMonthly payment
Date loan beganInitial loan amountInitial loan termOutstanding balance
Loan 3
Type of loanName of lenderMonthly payment
Date loan beganInitial loan amountInitial loan termOutstanding balance
Loan 4
Type of loanName of lenderMonthly payment
Date loan beganInitial loan amountInitial loan termOutstanding balance
INVESTMENTS
Investments 1
Type of investmentName of bank, insurer, financial body
Current balanceValue at maturityMonthly amount invested
Investments 2
Type of investmentName of bank, insurer, financial body
Current balanceValue at maturityMonthly amount invested
Investments 3
Type of investmentName of bank, insurer, financial body
Current balanceValue at maturityMonthly amount invested
Investments 4
Type of investmentName of bank, insurer, financial body
Current balanceValue at maturityMonthly amount invested
ADDITIONAL SERVICES (YES/NO)
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