The
	equityRelease
		Centre

MORTGAGE QUESTIONNAIRE

Equity from your home can also be released by taking a further advance, When arranged in association with a re-mortgage the increased cost may be minimal as we can often obtain our clients a lower interest rate on their existing mortgage. So if you would like to save pounds on your mortgage then simply complete our enquiry form and a highly trained professional adviser who has access to the very latest rates on approximately 5,000 different schemes will call you back to discuss your requirements in person.

Please complete the form below and click "Submit". The items marked * are required. Please enter 0 (zero) if applicable. The information collected will be used solely for the purposes of providing background information when contacting you.

Alternatively should you hate filling in forms and would prefer us to ask you the questions, simply call us on 0118 958 8810.

Applicant 1

Applicant 2

Title:

Forename or initials:

Surname:

Date of birth:

dd/mm/yyyy

Address:

Postcode:

Marital status:

Contact telephone:

E-Mail:

Fax:


YOUR CIRCUMSTANCES
Employment status:	*

Employed gross basic annual earnings:	*£	£ (do not use commas)

Other income per annum:
- from guaranteed overtime/bonus	*£	£
- from regular overtime/bonus	*£	£
- from second job	*£	£
- from investments	*£	£

Self employed: net trading profit
- last year	*£	£
- previous year	*£	£
- year before	*£	£

Loans/credit cards outstanding (excluding current mortgage if to be cleared):	£ due to finish (approx)	£ due to finish (approx)

Monthly repayments on the above:	£	£


REASON FOR ENQUIRY	*

PROPERTY TO BE BOUGHT/REMORTGAGED

Purchase price/approximate value:	*£

MORTGAGE REQUIRED

Amount and type:	*£	*

Term and rate preferred	* years	*

Existing mortgage lender, if any

OTHER INFORMATION OR COMMENTS:
I have read your Key facts about our services and Privacy Statement and I authorise you to use this information to acknowledge receipt of my information and to communicate with me regarding my enquiry. I would like to receive other relevant information and offers from The equityRelease Centre. (If you do not want to receive other information please untick box)

How did you find us?
Which search engine/site did you come from?

what search term did you use?


By submitting this form you agree to an advisor contacting you.

Your home may be repossessed if you do not keep up repayments on your mortgage.

For researching and arranging the best Interest Only Mortgage scheme for you, we will make a charge. This can be paid by you either as a fee, usually 2.5 % of the loan payable on application to the lender, but subject to a minimum of £1450 and any commission we receive from the lender will be refunded to you, or a combination of fee and commission, so that the total remuneration received would not be less than £ 1,450 . We would retain any commission received from the lender towards this fee. Where the commission received is less than £1450 you would pay a fee for the balance on completion.

The equityRelease Centre
8a Richfield Avenue
Reading
Berkshire
RG1 8EQ
Tel: 0118 958 8810

e-mail:
enquiries@uk-equity-release-centre.co.uk

Principal:
Keith Hargraves

The equityRelease Centre is a trading style of Advice on Money which is an appointed representative of Sesame Ltd, which is authorised and regulated by the Financial Services Authority. Sesame is entered on the FSA register (www.fsa.gov.uk/register/) under reference 150427.

The information contained in this web site is for general information only and is not financial, investment or tax advice. It is also subject to the UK regulatory regime and is therefore restricted to consumers based in the UK. If you would like to discuss a particular issue or generally ask us how we can advise on your particular situation then please contact us.

For researching and arranging the best scheme for you, we will make a charge. This can be paid either by you as a fee, usually 2.5% charged on completion with any commission received from the lender refunded to you, or a combination of fee and commission, usually 1.5% fee charged on completion and 1% commission received from the provider.

Please read our Privacy Statement before sending any enquiry form or email to us.

MORTGAGE QUESTIONNAIRE

Applicant 1

Applicant 2

YOUR CIRCUMSTANCES

PROPERTY TO BE BOUGHT/REMORTGAGED