A supplementary form is required for guarantors and additional applicants. A: APPLICANTS First Applicant Second Applicant

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4 Market Square Stafford ST16 2JH Tel: 01785 223212 Fax: 01785 250709 Email: mutual@srbs.co.uk Indirect Mortgage Application Form A supplementary form is required for guarantors and additional applicants A: APPLICANTS First Applicant Second Applicant Title (Mr/Mrs/Dr etc) Surname Forenames(s) Previous Surname Date of Birth National Insurance No Nationality Expected Retirement Age Telephone (Home) Telephone (Mobile) E-Mail Address Dependent Children Names and Dates of Birth Present Address Residential Status Time at this address Years Months Years Months Previous Address (if less than 5 years) If more than one please use Section Z Years Months Years Months

B: SOLICITOR Solicitor Acting Name of Firm Address It is the Society s policy not to use sole practitioners outside the Stafford area. If you decide to continue with your choice of solicitor the Society will instruct separate solicitors to act on its behalf and you will be responsible for their fees C: INCOME and EMPLOYMENT Name and address of Employer/business First Applicant Second Applicant Job Title Length of service: if less than 3 years give details of previous job in section Z Years Years IF EMPLOYED Basic Annual Income (Gross) Regular Overtime/Bonus/ Commission (Gross) Pension Income (Gross) Rental Income (Gross) per annum per annum IF SELF EMPLOYED Net profit or Directors Remuneration and Dividends Year to Year to Year to Year to Year to Year to Name and address of Accountant (For some applications, only Accountants with suitable qualifications are acceptable)

D: MORTGAGE REQUIRED Mortgage Product required Details of mortgage required Type of mortgage required Total Amount Required Amount required on a repayment basis Term of Loan Years Amount required on an interest-only basis Purpose of mortgage Please tick (give details in section Z) House Purchase Remortgage Capital Raising Home Improvements Debt Consolidation If Capital Raising please state purpose If you have applied for an interest-only mortgage please show how you intend to repay your mortgage at the end of the term for which you have applied. Sale of Property Maturity of Investment Other (specify in section Z) E: OUTGOINGS OF APPLICANTS AND GUARANTORS Please list below details of all existing residential and Buy to Let mortgages, Loans (including student loans and pay day loans), hire purchase, credit cards (including 0% transfers), maintenance payments or other existing outgoings. Please also include details of any rent you are paying at present. For re mortgage applications please state the details of the mortgage being repaid. LEAVING THIS BOX BLANK WILL DELAY YOUR APPLICATION. Name of Lender/Creditor Type of commitment Total Owing Monthly payment In the name of To be repaid At completion Y N

F: DETAILS OF PROPERTY TO BE MORTGAGED Address Name and address of vendor or selling Address of guarantee property (if applicable) Agent Homebuyers Report Required? (more in depth survey) Y/N Phone Number Phone Number Purchase Price/ Current Value Value of guarantee property Please tick the box if this Date of construction Is a Right to Buy application Please tick and/or complete all that apply House Semi Detached No. of Living rooms Flat Terraced (End/Mid) No of Bedrooms Maisonette Freehold No. of Kitchens Bungalow Leasehold No. of Bathrooms Floors (Flat Only) see below Unexpired term of lease No. of Toilets Detached Maintenance Charge No. of Garages If Leasehold, at the end of the mortgage term there must be at least 75 years unexpired left on the lease. If purchasing a flat there is a minimum property value of 250,000 if the flat is located above the fourth floor. If the property is less than 15 years old, is there an NHBC certificate, or certificate from a registered architect? Please give details in Section Z. If the property has been subject of a Right to Buy or Rent to Mortgage agreement within the last three years, please give details in Section Z. G: OTHER INFORMATION Please answer the following questions very carefully. Any incorrect answer may lead to your application being declined. Is the advance required for the purchase of the property? Is the property for the applicants own occupation? Are all applicants ordinarily resident in the United Kingdom? Is any other money towards the purchase price being borrowed? Will the property be occupied by anyone over the age of 17 other than the applicant(s)? Has any applicant ever been made bankrupt or had a county court judgement, default or IVA registered against them in the last 5 years? Has any applicant ever missed any payments on loans or credit cards or exceeded their overdraft limit? Has any applicant ever been in arrears with mortgage or rent payments? Are you a first time buyer? If you have circled any of the shaded boxes, then please provide further details in Section Z.

H: BUILDINGS INSURANCE The Society s valuer will provide an Insurance valuation which is, in his opinion, the sum required to rebuild the property in the event of total destruction. The property must initially be insured for this amount. Full instructions regarding the Society s requirements for buildings insurance will accompany your offer. I: OCCUPIERS Please list the full names and dates of birth of all those (excluding the applicants) who live/will live in the property described in Section F. If the property is/is to be tenanted it is sufficient to state Tenanted by single family unit or Tenanted multi occupancy (e.g. students/separate bed sits). NAME DATE of BIRTH NAME DATE of BIRTH J: FUTURE SPENDING PLANS Please provide details, including amounts, of any large financial transactions/plans for the next three years e.g Mortgage Redemption, Home Improvements, Holiday etc. Please continue on a separate sheet if necessary EXPENDITURE TYPE AMOUNT K: MARKET RESEARCH Please indicate which of the following best describes your reason for applying to the Society. Leaflet drop Shopping around Local Radio/Press Advert Personal recommendation Existing Society member National Radio/Press Advert Professional recommendation One off promotion Affinity Promotion To be completed by Intermediary Name of Broker: FCA Number: L&G agency number: Business Address: Email address: Contact Telephone Number: Please circle the level of service which you have given Recommendation Information Only Please tick here to confirm that you have issued a KFI for our mortgage product The Society is required to include in the APR any fee which you charge the borrower. Please indicate the fee charged in the box. Please indicate who procuration fees are payable Please indicate which mortgage club you belong to: Legal & General Other: Please indicate which mortgage network you are part of: This will be issued by cheque. Cheques can only be made payable to a company and T individual introducers. Please tick to confirm you have completed and attached the budget planner.

Z: SUPPLEMENTARYINFORMATION Please provide additional details or any further information which you wish to draw to the Society s attention. Where appropriate, please indicate the section to which the additional information relates. Enclosing the following documents where appropriate will assist in the processing of this application. Please tick items enclosed. Last P60 Copy of Estate Agents sale particulars Copy of recent Mortgage statement L a s t 3 years accounts Last 3 months pay slips Last 3 months Bank statements

AGREEMENT AND DECLARATION Each applicant who signs below agrees and declares: 1. That if this application is made in joint names, the mortgage interest payments in connection with any loan made by the Society will be made for and on behalf of all applicants, and that the mortgage is for the benefit of all applicants. 2. That to the best of their knowledge and belief the answers given are true and all material information has been disclosed. 3. That they will inform the Society immediately of any change in the information given in this application. 4. That the Society may make such enquiries of its credit reference agency, any past or present employers or other sources, as it considers necessary and that if this application is granted, the Society may pass on to such an agency information relating to the conduct of the account. If this is done, details of the account may be seen by other organisations that make searches. 5. That they will be responsible for the costs of the Society s solicitors whether or not the loan is completed. 6. That they accept that the Society may, at any time before any loan offered is completed, withdraw, revise or cancel the offer. 7. That the Society will make searches about them at credit reference agencies which will supply the Society with credit information as well as information from the Electoral register. The agencies will record details of the search whether or not this application proceeds. Credit searches and other information that is provided to the Society about them and those with whom they are linked financially will be used by the Society in assessing this mortgage application. 8. That the information given will be the basis of the contract and if necessary this application shall be a proposal by them to an insurance company providing insurance cover for the Society where additional security protection is required. Any confidential information required by the insurance company either before or after completion of the loan may be given by the Society and they will pay any charge in connection with the Society arranging any additional security protection. 9. That if the Society offers a loan, they authorise any solicitor acting on their behalf to disclose to the Society information relevant to the Society s decision to lend and they waive any right of solicitor-client confidentiality or legal professional privilege in respect of such information. A copy of this application may be provided to the solicitor. 10. That they have not been convicted of or charged with but not yet tried for any criminal offence other than motoring offences. (This declaration does not apply to convictions regarded as spent by virtue of the Rehabilitation of Offenders Act 1974). 11. That some or all of the data given in this application may be processed by the Society and used in accordance with its registration under the Data Protection Act. They acknowledge that they have the right of access to any such records and to any other information about them held by the Society, on application to the Chief Executive addressed to the Society s principal office and for which a fee may be charged. They also have the right of access to their personal records held by the credit agency used by the Society. They understand that the Society will supply the name and address of any such agency on request. 12. That they understand that if a mortgage valuation is required the report is not a structural survey and is prepared solely for the use of the Society in considering this application, and no responsibility for the value or condition of the property is implied or accepted by the Society or valuer. 13. That they agree that the Society may at any time assign, transfer or charge the mortgage granted to it to secure the loan for which they are applying and that the assignee, transferee or chargees may not itself be a building society or associated body of a building society. They understand that upon assignment or transfer they will cease to be a borrowing member of the Society. 14. They understand that if any answer has been written by any other person, that person shall for that purpose be regarded as acting for them and not for the Society. 15. They confirm that they have read the information notice on the back page of this application. 16. They understand that the Society will only be able to instruct their solicitor to act on its behalf if the firm has more than one partner (except in Stafford where single partner practices are permissible). In the event that the Society is not able to use their solicitor they understand that the Society will instruct its own solicitors. Their charges in this matter will be deducted from the sum which is forwarded to your solicitor. 17. They confirm that they are willing and able to make the repayments required in respect of the mortgage applied for. 18. That in signing this application they authorise the Society to disclose relevant confidential financial information to any third party guarantor. 19. That they understand that the Society will carry out an electronic search to verify their identity and address and that by signing this declaration they consent to such a search being carried out. If such a search is unsuccessful they further understand that the Society may request documentary evidence of their identity and address before this application can be processed. 20. That by signing this application they consent to the use of their personal information as specified in the paragraphs above. 21. That the Society will use the applicant s information for the purposes of considering the application and administering the mortgage. 22. That the applicant authorises the Society to share information with third parties about the conduct and operation of the mortgage account. 23. The Society may write to you from time to time about other products or services which may be of interest. However if you do not wish to receive direct marketing information by any means from the Society please tick this box. Please sign and date below where indicated below Applicant 1 Applicant 2 Date Guarantor 1/Applicant 3 Guarantor 2/Applicant 4 Date Stafford Railway Building Society is authorised by the Prudential Regulation Authority and regulated by the Prudential Regulatory Authority and the Financial Conduct Authority. Registration No. 206063. www.fsa.gov.uk/register. Please complete the direct debit and the reference authorities overleaf. Do not forget to read the information on the back cover.

FOR SOCIETY USE ONLY Insurance Co Valuation IPT at % = Date Loan 75% Value Premium Guarantee Repayments Capital and Interest at % Interest only StandardClauses and Conditions Interest only Y / N Other residents Y / N Fire Insurance 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 41 Other conditions non-standard clauses Income (1) (2) (F) TOTAL Fees included in the APR are Solicitors fee for 1st property Brokers fee Secured guarantee fee Land registry fees HLC Valuation fees TT fee Unsecured guarantee fee Lenders Reference Other fees The borrower has the ability to repay this mortgage from Income using affordability calculator Income as specified on review application Sale of property Sale of property other Maturity of investments Other see review application COMMENT ON RETIREMENT / INTEREST ONLY Mortgage Type A B C Initial Date Approved in principle - non FTF Approved in principle and correct procedures followed - FTF Approved following review

IMPORTANTINFORMATIONFORALLAPPLICANTSANDGUARANTORS Before you apply for a mortgage Government mortgage regulation took effect from the 1st November 2004. This covers all first charge lending where at least 40% of the property in question is used as or in connection with a dwelling by the applicant or a close family member. All other mortgages are not covered by mortgage regulation. The Society believes that it is right to treat all borrowers in the same way but you should be aware that if your application is not covered by the definition above, then none of the protection which is available under mortgage regulation will apply to your mortgage. Please also note that if mortgage regulation does apply, then before completing this application form you must have been issued with an initial disclosure document and a pre-application illustration (PAI) also sometimes referred to as a key facts illustration (KFI). It is very important that you have read and fully understood the illustration before submitting your application. Although the Society accepts applications from Mortgage Introducers it does not appoint agents for mortgage business. Accordingly the Society cannot accept responsibility for the actions of any Intermediary acting on your behalf. After youapplyforamortgage The Society does not sell its mailing list and does not as a matter of course offer additional services through the post, although one off mailings may be made on rare occasions. If you do not wish to receive such information, please advise the Society in writing. You have the right to change this election at any time. After yourmortgage isgranted You may make mortgage payments by Direct Debit, Standing Order, by transfer from an investment account with the Society by electronic transfer or by cash/cheque direct to the Society. To prevent your mortgage being in arrears all mortgage payments must reach the Society no later than the last working day monthly and for this reason Direct Debit is the preferred payment method. The Society will forward a statement of your mortgage account each year, and you should check it carefully and notify the Society as soon as possible if you have any queries. Your home may be repossessed if you do not keep up your repayments on your mortgage.

Please fill in the whole form using a ball point pen and send it to: Stafford Railway Building Society 4 Market Square Stafford ST16 2JH Instruction to your Bank or Building Society to pay by Direct Debit Originators Identification Number 9 2 2 7 7 1 Reference Number Name(s) of Account Holder(s) Instruction to your Bank or Building Society Bank/Building Society account number Please pay Stafford Railway Building Society Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with Stafford Railway Building Society and, if so, details will be passed electronically to my Bank/Building Society Branch Sort Code Name and full postal address of your Bank or Building Society To the Manager Bank Building Society Signature(s) Address Postcode Date Banks and Building Societies may not accept Direct Debit Instructions for some types of account This guarantee should be detached and retained by the Payer. The Direct Debit Guarantee This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits. If there are any changes to the amount, date or frequency of your Direct Debit, Stafford Railway Building Society will notify you ten working days in advance of your account being debited or as otherwise agreed. If you request Stafford Railway Building Society to collect a payment, confirmation of the amount and date will be given to you at the time of the request. If an error is made in the payment of your Direct Debit by Stafford Railway Building Society or your bank or building society you are entitled to a full and immediate refund of the amount paid from your bank or building society. If you receive a refund you are not entitled to, you must pay it when Stafford Railway Building Society asks you to. You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

EMPLOYEE REFERENCE SLIP Applicants full name The Society will send for references from your employer. To enable us to process your application speedily please complete all relevant sections please print clearly. FAO: Name and address of your employer Present address Payroll Reference Post Code Employers email address I authorise you to supply Stafford Railway Building Society with such information about me as they may request. Signed Post Code Date Applicants full name The Society will send for references from your employer. To enable us to process your application speedily please complete all relevant sections please print clearly. FAO: Name and address of your employer Present address Payroll Reference Post Code Employers email address I authorise you to supply Stafford Railway Building Society with such information about me as they may request. Signed Post Code Date