Mersey Mortgage - In-Principle Secured Loan Application

Any field marked * is obligatory for 1st named!	1st Applicant's Details	2nd Applicant's Details
Email address: *
Title:
Forename(s): *
Surname: *
Date of birth: *
Address: *
Postcode: *
Time at above address: *	Years Months	Years Months
Home Telephone: *
Work Telephone:
At your present property, are you:
	Employment	Details
Occupation: *
Are you?:
Income: *	per annum	per annum
Time in Current Employment:	Years Months	Years Months

		Loan or Mortgage Details
	Loan Type: *
	Amount of loan required: *
	Term of loan: *	Months
	Purpose of Loan *
		Property Details
	Property Purchase Price or Estimated Value: *
	Purchase Date: *
	Type of Property: *
	Tenure:
	Name & Address of current Building Society or Lender: *
	What is the balance on your existing mortgage: *
	What is the monthly mortgage repayment: *
	How much arrears: *
		Other Details
	Enter any other relevant information here: ie. CCJs, defaults etc. including dates and amounts * (if none, state 'none')
	Space for your comments:
	How did you find our web site?
	if other

	NOTICE UNDER THE DATA PROTECTION ACT 1984 I/We agree the information given in this application may be used to get credit reference searches which will be recorded and disclosed on any other credit search. I/We agree you or any lender you submit this application to may ask any party to verify the information. I/We agree this information and the details and conduct of any loan I/We obtain, may be recorded in any reference agency and updated and used by any lender and others in making credit decisions about me/us and other members of my/our household, tracing debtors and controlling fraud. I/We agree lenders may release information to their own funders or insurers and advisers. I/We agree the information may be used to offer products which you, or any other company you have given it to believe may interest me/us unless I/We tell you and any relevant company not to in writing. I/we agree

Please check your entries before submitting this form