1 BROKER DETAILS Broker Name Company Name Email Principal firm or network Contact number FCA. / Interim permission Office telephone number DA AR Authorisation 2 NEW LOAN DETAILS Loan required Term of loan Fixed rate Tracker rate Standard variable rate Purpose of loan Planned retirement age 3 APPLICATION DETAILS Title Forename Title Forename Middle name(s) (Required) Middle name(s) (Required) Surname Surname Maiden Name / Previous Name (Required) Date of birth Maiden Name / Previous Name (Required) Date of birth Number of dependents / ages Marital status Number of dependents / ages Marital status Current address - Please provide a full 3 year history, if less than 3 years Current address - Please provide a full 3 year history, if less than 3 years Time at current address Time at current address Home telephone number Mobile telephone number Home telephone number Mobile telephone number Email address Email address Nationality Nationality Are you a UK resident? Are you a UK resident? How long have you lived in the UK? Permanent right to reside in UK? How long have you lived in the UK? Permanent right to reside in UK? Page 01 of 05
4 PREVIOUS ADDRESS DETAILS Previous address - If at current address less than 3 years Previous address - If at current address less than 3 years Time at address Time at address 5 EMPLOYMENT AND INCOME DETAILS If under 12 months employment history, provide a full 12 months history Occupation If under 12 months employment history, provide a full 12 months history Occupation Employer name Contact number Employer name Contact number Employer address Employer address Period of employment Period of employment Annual basic Guaranteed overtime Bonus Annual basic Guaranteed overtime Bonus Other income TOTAL NI Number Other income TOTAL NI Number Are you currently in a probation period? Full time Part time Contracted Are you currently in a probation period? Full time Part time Contracted 6 SELF EMPLOYED Company trading name Company trading name Nature of business Ltd. / LLP / Sole Trader Nature of business Ltd. / LLP / Sole Trader How long trading Are there 3 years accounts? How long trading Are there 3 years accounts? Percentage shareholding Percentage shareholding Is there a company accountant Is there a company accountant Page 02 of 05
6 SELF EMPLOYED ~ CONTINUED If a limited company, confirm last 3 years salary and dividends for each If a limited company, confirm last 3 years salary and dividends for each Year 1 Year 1 Year 2 Year 2 Year 3 Year 3 7 SECURITY PROPERTY DETAILS House Terraced Bedrooms Freehold Purchase date Purchase price Flat Semi Reception Leasehold Ex local authority Present value Bungalow Detached Bathrooms Years remaining Standard construction If flat,. of floors Other Garage Monthly rent received (if BTL application) Security address if different to current 8 CURRENT RESIDENTIAL MORTGAGE (FOR BTL SEE SECTION 9) Current mortgage lender Existing mortgage balance Monthly repayment Current interest rate Current arrears Highest arrears (last 24 months) Account. Any other loans against the property Current total balance Monthly repayment Current arrears Highest arrears (last 12 months) Lender Account. 9 BTL MORTGAGES / OR ATTACH A FULL COPY OF YOUR PROPERTY PORTFOLIO Applicant Lender Balance Monthly payment Rent received 1 2 Joint Account number Page 03 of 05
10 CREDIT HISTORY Have you ever been bankrupt / repossessed? Have you ever been bankrupt / repossessed? Have you ever had a County Court judgment (or decrees) registered against you? Have you ever had a County Court judgment (or decrees) registered against you? Have you ever had any arrears? Have you ever had any arrears? Have you ever had any defaults registered against you? Have you ever had any defaults registered against you? Do you have any existing or previous payday loans? Do you have any existing or previous payday loans? Have you entered into any IVA or debt management plan? Have you entered into any IVA or debt management plan? If yes, provide dates registered, amounts, dates satisfied and reasons in below: If yes, provide dates registered, amounts, dates satisfied and reasons in below: 11 MONTHLY EXPENDITURE Household bills and services Living costs Household bills and services Living costs Childcare Travel & motoring Childcare Travel & motoring Leisure & recreation Ground rent & service charge Leisure & recreation Ground rent & service charge Monthly maintenance CSA or alimony payments Additional expenditure Page 04 of 05
12 ADDITIONAL INFORMATION 13 CONSENT & DECLARATION Borrower(s) Declaration: By signing this form, I/we confirm the information given is accurate and that you, or any lender to whom you submit this application, may use and disclose my data as described. I/we understand that either your company or those deemed appropriate may contact me/us by post, phone, email or other means as deemed necessary. I/we understand that you will receive a commission from the lender if my/our loan completes. I/we also give permission to Brightstar Financial Limited, or the introducer, to search files or credit reference agencies which will keep a record of the search. I acknowledge that multiple credit searches may affect my ability to obtain credit elsewhere. Applicant 1 Print name Signature Date Applicant 2 By ticking this box I agree all the above. Please except this as my signature. Broker Declaration: I/we confirm that we have obtained informed consent from my/our clients to submit this application to you and for you to make any credit reference or other checks as you deem necessary to process their application. I/we further confirm that I/we agree that I/we are responsible for advice given to our clients regarding their financial circumstances and the suitability of this loan for their needs, and for disclosing to them the commission that I/we will receive from you. Signature Date Your Information: From time to time we would like to send you information about Brightstar products and services we believe may be of interest. If you would like to receive this information please opt-in by ticking the following box: CONTACT OUR HELPDESK: 01277 500900 OR EMAIL: HELPDESK@BRIGHTSTARHUB.CO.UK THINK CAREFULLY BEFORE SECURING OTHER DEBTS AGAINST YOUR HOME. YOUR HOME MAY BE REPOSSESSED IF YOU DO NOT KEEP UP REPAYMENTS ON A MORTGAGE OR ANY OTHER DEBT SECURED ON IT. Brightstar Financial Limited is authorised and regulated by the Financial Conduct Authority. Our Financial Services Register number is 712700. You can check this on the Financial Services Register by visiting the FCA s website www.fca.org.uk/register or by contacting the FCA on 0800 111 6768. Brightstar Financial Limited. Registered office 3 Tunnel Hill Mews, Knock Lane, Blisworth, rthampton, rthamptonshire, NN7 3DA. Registered in England and Wales Company no: 07462342. Page 05 of 05