Client enquiry

Client Enquiry Form

"*" indicates required fields

Step 1 of 4 - Personal Details

25%

Please complete the fields below to the best of your ability.

The more information you provide us with, the more accurate we can be.

Which adviser would you like your enquiry to go to?

Please give us a short summary of why you're getting in touch and how we can help you.

How did you hear about us?

Personal Details

Please fill out the fields for the first applicant below. If there is a second / joint applicant then check the box and complete the additional fields for the second / joint applicant.

Full Legal Name (first applicant)*

First Middle Last

Date of Birth (first applicant)

Day

Month

Year

Nationality

Do you have indefinite leave to remain / settled status in the UK? (non-UK nationals)

Yes

Current Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date moved in to current address

Day

Month

Year

Is the property...?

Owned

Rented

Family home

Other

Current rent PCM

Have you been in your current property less than 3 years?

Yes

Previous Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date moved in to previous address

Day

Month

Year

Home telephone

Work telephone

Mobile*

Email*

Smoker status

I am a smoker

I used to smoke, but I gave up more than 12 month ago

I used to smoke, but I gave up within the last 12 months

I have never smoked

Nicotine replacement products

I use nicotine replacement products (including vaping)

Is there a second applicant?*

Yes

Full Legal Name (second applicant)

First Middle Last

Date of Birth (second applicant)

Day

Month

Year

Nationality (second applicant)

Do you have indefinite leave to remain / settled status in the UK? (non-UK nationals) (second applicant)

Yes

Is your current address the same as applicant 1?

Same address

Different address

Current Address (second applicant)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date moved in to current address (second applicant)

Day

Month

Year

Is the property...? (second applicant)

Owned

Rented

Family home

Other

Current rent PCM (second applicant)

Have you been in your current property less than 3 years? (second applicant)

Yes

Previous Address (second applicant)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date moved in to previous address (second applicant)

Day

Month

Year

Home telephone (second applicant)

Work telephone (second applicant)

Mobile (second applicant)

Email (second applicant)

Smoker status (second applicant)

I am a smoker

I used to smoke, but I gave up more than 12 month ago

I used to smoke, but I gave up within the last 12 months

I have never smoked

Nicotine replacement products (second applicant)

I use nicotine replacement products (including vaping)

Do you have any dependents under the age of 18?

Please only declare shared dependants once

Yes

Please enter the month and year of birth for each dependent. You can add more by clicking the 'Add dependent' button.

Dependents

Month and Year of birth

Do you have childcare costs?

Yes

How much are the monthly total childcare costs?

Do you pay spousal or child maintenance?

Yes

How much are the monthly maintenance costs?

Who is responsible for these maintenance costs?

Employment

Do you have employed income?*

Yes

(If you are company director with shares select 'No' and go to Self-Employed)

Name of Employer

Occupation

Contract type

Permanent

Temporary

Fixed

Employment Start Date

Day

Month

Year

Employment End Date

Day

Month

Year

Basic salary

Car allowance / similar

Bonus / commission / overtime in the last 3 months

Bonus / commission / overtime in the last 12 months

Average net pay monthly

Does applicant 2 have employed income?*

Yes

(If you are company director with shares select 'No' and go to Self-Employed)

Name of Employer (second applicant)

Occupation (second applicant)

Contract type (second applicant)

Permanent

Temporary

Fixed

Employment Start Date (second applicant)

Day

Month

Year

Employment End Date (second applicant)

Day

Month

Year

Basic salary (second applicant)

Car allowance / similar (second applicant)

Bonus / commission / overtime in the last 3 months (second applicant)

Bonus / commission / overtime in the last 12 months (second applicant)

Average net pay monthly (second applicant)

Do you have self employed income?*

Yes

(Sole Traders, Partnerships and Shareholding Directors of Limited Companies)

Are you a...?

Sole trader

Partnership

Limited Company

Company name

Occupation

Nature of business

Date business started

Day

Month

Year

Share of NET PROFIT for latest tax year

Share of NET PROFIT for previous tax year

Share of NET PROFIT for 2nd previous tax year

Latest Tax Year

Company profit BEFORE tax for latest tax year

Company profit AFTER tax for latest tax year

Directors salary for latest tax year

Net dividends drawn for latest tax year

Date of accounts / tax return for latest tax year

Day

Month

Year

Previous Tax Year

Company profit BEFORE tax for previous tax year

Company profit AFTER tax for previous tax year

Directors salary for previous tax year

Net dividends drawn for previous tax year

Date of accounts / tax return for previous tax year

Day

Month

Year

2nd Previous Tax Year

Company profit BEFORE tax for 2nd previous tax year

Company profit AFTER tax for 2nd previous tax year

Directors salary for 2nd previous tax year

Net dividends drawn for 2nd previous tax year

Date of accounts / tax return for 2nd previous tax year

Day

Month

Year

Does applicant 2 have self employed income?*

Yes

(Sole Traders, Partnerships and Shareholding Directors of Limited Companies)

Are you a...? (second applicant)

Sole trader

Partnership

Limited Company

Company name (second applicant)

Occupation (second applicant)

Nature of business (second applicant)

Date business started (second applicant)

Day

Month

Year

Share of NET PROFIT for latest tax year (second applicant)

Share of NET PROFIT for previous tax year (second applicant)

Share of NET PROFIT for 2nd previous tax year (second applicant)

Latest Tax Year (second applicant)

Company profit BEFORE tax for latest tax year (second applicant)

Company profit AFTER tax for latest tax year (second applicant)

Directors salary for latest tax year (second applicant)

Net dividends for latest tax year (second applicant)

Date of accounts / tax return for latest tax year (second applicant)

Day

Month

Year

Previous Tax Year (second applicant)

Company profit BEFORE tax for previous tax year (second applicant)

Company profit AFTER tax for previous tax year (second applicant)

Directors salary for previous tax year (second applicant)

Net dividends for previous tax year (second applicant)

Date of accounts / tax return for previous tax year (second applicant)

Day

Month

Year

2nd Previous Tax Year (second applicant)

Company profit BEFORE tax for 2nd previous tax year (second applicant)

Company profit AFTER tax for 2nd previous tax year (second applicant)

Directors salary for 2nd previous tax year (second applicant)

Net dividends for 2nd previous tax year (second applicant)

Date of accounts / tax return for 2nd previous tax year (second applicant)

Day

Month

Year

Do you receive income from any other sources?*

Yes

Source

Amount per annum

Does applicant 2 receive income from any other sources?*

Yes

Source (second applicant)

Amount per annum (second applicant)

Existing Finance

Do you have any loans, car finance, or hire purchase agreements?

Yes

You can add more by clicking the 'Add another' button.

Type of finance

Loan

Car finance

Hire purchase

Other

Lender

Monthly payment

Current balance

Months remaining

Reason for loan

What do you intend to do with this loan / finance balance?

If more than one applicant, who is responsible for this loan / finance?

Do you have any credit cards?

Yes

You can add more by clicking the 'Add another' button.

Lender

Current balance

Cleared each month?

Yes

Typical monthly payment

What do you intend to do with this credit card balance?

If more than one applicant, who is responsible for this credit card?

Do you have any existing mortgages?

Yes

You can add more by clicking the 'Add another' button.

Lender name

Current balance

Term remaining

Monthly payment

Value of property

Repayment type

Current interest rate

Mortgage type

Fixed rate

Tracker

Variable rate

Other

Is the mortgage...?

Residential

Buy to Let

Monthly Rent Received (if BTL)

Penalty if repaid?

Yes

Date this deal / penalty ends

Day

Month

Year

If more than one applicant, who is responsible for this mortgage?

Credit history

Please give us a summary of any issues with credit, including arrears, missed payments, defaults, CCJs, IVAs, bankruptcy, repossessions

Requirements

You can add more by clicking the 'Add another' button.

Is it a new purchase or a remortgage?

Purchase

Remortgage

Will the mortgage be for...?

Buy to let

Residential

Monthly rental income (if Buy-to-let)

Please enter a number from 1 to 10000.

Estimated property value (or purchase price)

Please enter a number from 50000 to 10000000.

Mortgage amount required (approx.)

Please enter a number from 5000 to 10000000.

Deposit (purchases only - approx.)

Please enter a number from 1000 to 10000000.

Do you have any particular requirements we should know about?

Such as a preference for a particular product type or the overall mortgage term.

Existing policies

Do you have any existing life insurance / critical illness cover / income protection / redundancy cover? If so, please provide details if possible.

Do you (or any additional applicants) have any physical or mental impairment, disability or vulnerability that you’d like to make us aware of so we can better tailor our service to you?

If yes, please feel free to add some extra information in the next additional notes section

Yes

Any other notes

Please use this section to add any other information not already covered.