Standard AIP Form » Intermediaries | Countrywide Mortgage Centres

satellite agreement in principle form

intermediaries

Consultant Name:

Purchase Remortgage Buy to Let Let to Buy RTB
Repayment Interest Only Status Self Certification

Purchase Price: £ Loan: £ Term: years LTV:

House Flat Maisonette

Ex-Local Authority: Yes No

PERSONAL DETAILS

1st Applicant

2nd Applicant

Title (Mr/Mrs/Miss)

Forenames

Surname

Previous/Other Name

Date of Birth

Current Address

Postcode:

Time at Address

Years Months

Home Telephone No.

Previous Address:

Please provide FULL address details for the last 3 years ( use additional information box if necessary )

Time at Address

Years Months

Are you a first time buyer?

Yes No

Current Residential Status

Marital Status (Single/Married)

Number of Dependants

Ages

EMPLOYMENT STATUS

1st Applicant

2nd Applicant

Employment Status

Employed Self Employed

Accountant?

Yes No

Time in Current Employment

Years Months

FULL 12 Months employment history required ( use additional information box if necessary )

Job title

Gross annual basic income

Gross annual o/time / comm etc

Gross annual other income

Total Income

Employers Telephone No.

Contract Type (Perm/Temp/Contract)

CREDIT DETAILS

1st Applicant

2nd Applicant

Do you have a current account?

Yes No

Number of years held:

Have you ever been bankrupt?

Yes No

If yes, please provide details in Additional Infomation box

Have you had any rent/mortgage arrears?

Yes No

If yes, when in last 12 months?

Have you any defaults?

Yes No

If yes, please provide details in Additional Infomation box

Have you any CCJs?

Yes No

If yes, please provide details in Additional Infomation box

Number of credit/store cards:

COMMITMENTS (Including Mortgage/Loans/Credit Cards/Credit Agreements)

APP 1/2 JOINT	LENDER	MONTHLY AMOUNT	O/S BALANCE	REPAID ON COMPLETION

ADDITIONAL INFOMATION

Do you want a credit search done? Yes No

If yes which Lender and Rate?

DECLARATION

I HAVE RECEIVED PERMISSION FROM THE ABOVE CLIENTS TO ACT ON THEIR BEHALF IN RESPECT OF THIS APPLICATION AND FOR ALL INFORMATION RELATING TO THIS APPLICATION TO BE MADE AVAILABLE TO ME. THE INFORMATION ON THIS APPLICATION WAS OBTAINED FAIRLY AND IS TO THE BEST OF MY KNOWLEDGE TRUE. I HAVE RECEIVED PERMISSION FROM MY CLIENTS TO PASS THIS APPLICATION TO COUNTRYWIDE MORTGAGE CENTRES.(CMC) WHO WILL USE THE INFORMATION ON THIS APPLICATION TO TRY AND SECURE MORTGAGE LENDING FOR THEM. MY CLIENTS GIVE CMC PERMISSION TO PASS THIS INFORMATION TO THIRD PARTY LENDERS FOR THE PURPOSE OF ASSESSING THIS APPLICATION. MY CLIENTS GIVE THE LENDER TO WHICH CMC HAS PROVIDED THIS INFORMATION PERMISSION TO MAKE SEARCHES ABOUT THEM WITH CREDIT REFERENCE AGENCIES THAT WILL SUPPLY THEM WITH CREDIT INFORMATION FOR USE IN ASSESSING THIS APPLICATION AND VERIFYING THEIR IDENTITY. I HAVE ADVISED MY CLIENTS THAT WHEN SUCH SEARCHES TAKE PLACE, A RECORD OF THE SEARCH WILL BE RECORDED AT THE AGENCY WHETHER OR NOT THE APPLICATION PROCEEDS.

Company FSA No.

By submitting this form you are accepting the declaration attached to it.

Countrywide Mortgage Centres, Sovereign House, Hockliffe Street, Leighton Buzzard, Bedfordshire, LU7 1GT.

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