MORTGAGE DATA CAPTURE FORM

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1 MORTGAGE DATA CAPTURE FORM LOAN REQUIREMENTS Rates Schedule Product M1 - LIBOR Tracker - 70% Rate Initial Rate 2.99 Mortgage Amount 190, Lower Estimated Property Value / Purchase Price 350, LTV 54.29% Repayment Type Term Repayment 25 years Mortgage Type Mortgage Remortgage Is the purchase undervalue Desired Completion Date (n/a) Number of Sources of Deposit 1 Source of Deposit Equity in Property Any Additional Builder Incentive APPLICANT Title Mr Mrs First Name Middle Name Surname Previous First Name Previous First Middle Name Previous Surname Date of Birth 4 March March 1990 Expected Retirement Age Relationship to First Customer Partner Telephone Numbers Please enter at least one Home Home Work Work Mobile Mobile National Insurance Number Nationality Has the Applicant ever owned their own property? Any unspent Criminal Convictions?

2 ADDRESS History (A 3 year address history is required, please complete additional address history on the supplement sheet provided) Residential Status 5 The Crescent, KT22 8DY, Living with Family / Friends Residential Status 5 The Crescent, KT22 8DY, Living with Family / Friends Date until 29 June 2017 Date until 29 June 2017 Date from 9 March 2014 Date from 9 March 2014 Landlord Company Name / Housing Association / Council Landlord Landlord Contact Name Landlord Landlord Tel EXISTING MORTGAGE Lender Name Outstanding Mortgage Amount Account Number EMPLOYMENT Employment Status Employed Self Employed Sector IT Contracting Human Resources Type of Employment CIS Type of Self Employment Limited Company Employed / Contract Job Title Contractor HR Services Employment Start Date 04 March 2013 Contract End Date Company Name IT Contractor Limited Company 13 The Crescent, KT22 8DY, Company Telephone Number Company Contact Name for Reference Employee / Payroll Number Self-employed: Date Business Established 09 February 2014 Business Name J Contract Limited

3 Registered 5 The Crescent, KT22 9DY, Business Telephone Number Percentage Shareholding 100% Company Registration Number (if applicable) Employed: Number of Previous Employments (Please complete additional previous employment information on the supplement sheet provided) Employment Status Employed Self Employed t Employed Employed Self Employed t Employed Sector Type of Employment Job Title Dates of Employment From To From To Second Employment Does the Customer have an Accountant? Accountant s Name 5 The Crescent, KT22 9DY, Accountant s Accountant s Telephone Number Accountant s Qualifications MAAT / FMAAT / AAT / MAA INCOME 2nd Job Basic Income: 2nd Job Basic Income: Basic Salary: Basic Salary: Guaranteed Commissions / Bonus / Overtime: Guaranteed Commissions / Bonus / Overtime: Investment / Share Dividend Income: Investment / Share Dividend Income: Gross Annual Income (Please refer to the income guidance sheet, which can be found on our website in the Essential Literature section) Long Term Maintenance: Long Term Maintenance: Long Term Maintenance: Long Term Maintenance: Pension: Pension: Regular Commission / Bonus / Overtime: Regular Commission / Bonus / Overtime: Share of Annual Net Profit (Ltd Co): Share of Annual Net Profit (Ltd Co): Share of Annual Net Profit (Sole Trader / Partnership): Share of Annual Net Profit (Sole Trader / Partnership): TOTAL TOTAL

4 Year Income Self Employed Share of Annual Net Profit 20 45, , Does the term extend beyond the applicant s intended or state retirement age? Gross Annual income in retirement Are the applicant(s) aware of any changes to their income that are likely to affect their ability to meet the mortgage payments? Details EXPENDITURE Ground Rent and Service Charges Payment Personal Goods Payment Council Tax Payment Utility and Telephone Bills Payment Clothing Payment Child Care, School and University Fees payment Household Goods Payment Housekeeping (Food and Washing) Payment Entertainment Payment Travel Payment MONTHLY EXPENDITURE Payment Payment Debts to be consolidated (Please complete additional debts to be consolidated on the supplement sheet provided) Balance Balance Lender Lender Account Number Account Number

5 MONTHLY EXPENDITURE Payment Payment Credit commitments (Please complete additional debts to be consolidated on the supplement sheet provided) Balance Balance Lender Lender To be repaid? To be repaid? Are the Applicant(s) aware of any changes to their expenditure that are likely to affect their ability to meet the mortgage payments? Details CREDIT PROFILE Discharged Bankruptcy / DRO in the last 72 months? Discharge Date: Discharge Date: Entered into an IVA? IVA Discharged? IVA Discharged? If ticked yes please provide End date: If ticked yes please provide End date: Entered into an DMP? DMP Discharged? DMP Discharged? Any arrears on mortgage(s) or any other credit commitment in the last 12 months? Any arrears on mortgage(s) or any other credit commitment in the last 12 months? Any arrears on rent payments in the last 12 months? Has the Applicant ever had a property repossessed? Date of repossession: Discharge Date: Repaid or repayment arrangement in place for any outstanding repossession shortfall? Date of repossession: Discharge Date: Repaid or repayment arrangement in place for any outstanding repossession shortfall? Were the credit difficulties the result of a Life Event? Type of life event: Date of life event: Why is the cause of the historic credit difficulties not expected to continue? Type of life event: Date of life event: Why is the cause of the historic credit difficulties not expected to continue?

6 Has the applicant ever had a CCJ? (For Credit Repair only please tick yes) (note - these questions are mandatory for Credit Repair only) Number of CCJs: Number of CCJs: Any CCJs within the last 3 months? Any CCJs within the last 3 months? BANK Account Number Sort Code Name Bank Name Limited Bank Name and 6 The Crescent, Surrery, KT22 8DY, Account in Names of 1st 2nd C & J Contract PROPERTY Security 1 Nelson Avenue, Minster on Sea, Sheerness, Kent, ME12 3SE, United kingdom Property Region (if the Security is unknown) South East Is the Security Property the Main Residence for all Applicant(s)? Ex-Local Authority Property Type Flat Terraced House Semi-detached House Detached House Bungalow Flat Type: Converted Flat Maisonette Purpose Built-Flat Studio Flat If property type Flat has been ticked please complete the Number of stories in block: On which storey is the flat: Is there a communal lift? Is the Security Property above / adjacent to commercial premises? Nature of Business of Commercial Premises Is the Property currently Under Construction? Year of Construction Builder Certificate Type Standard Construction

7 Floors Receptions Bedrooms Number of Rooms Kitchens Bathrooms WCs Garages Basements Tenure Will the property be used for Commercial Purposes? Freehold Agricultural Restrictions question please provide more details: Name Estate Agents / Auctioneers 8 The Crescent, KT22 8DY Contact name for valuer access Telephone Estate Agent Contact number for valuer access Valuer Viewing Instructions Name of Vendor / Builder Relationship to vendor Type of Valuation Required Mortgage Valuation Homebuyer and Mortgage Valuation SOLICITOR Name TLT LLP Solicitor Primary Contact Telephone Fax DX 1 Redcliff Street, South Gloucestershire, BS1 6TP United kingdom

8 BTL PORTFOLIO Do the applicant(s) own any investment or Buy to Let properties? Total number of properties in portfolio: Estimated value of portfolio: Total outstanding balance of all mortgage(s) in portfolio: Total monthly portfolio gross rental income: Total monthly portfolio mortgage repayment(s): ** te: All full Mortgage Applications must be submitted on the Magellan Hub via the Magellan website **

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