Intermediary mortgage data capture form
Intermediary mortgage data capture form Submit your client’s mortgage application online intermediary.tsb.co.uk Broker Name User ID FCA Number Contact Number Number of applicants Is this a remortgage? Yes No Level of service for this application Advised Execution only Level of service – execution only rationale High net worth Mortgage professional Intermediary fees Fee type Fee 1 Rejected advice Non-interactive sale Fee 2 Fee 3 Amount of fee £ £ £ £ £ How much of the fee is refundable? £ When payable On application On application On application Within 14 days completion Within 14 days completion Within 14 days completion On cancellation On cancellation On cancellation On completion On completion On completion Personal details Title Mr/Mrs/Miss/Ms/Dr/Other Applicant 1 Applicant 2 Forename 1 – as shown on id Forename 1 – as shown on id Forename 2 – as shown on id (if applicable) Forename 2 – as shown on id (if applicable) Forename 3 – as shown on id (if applicable) Forename 3 – as shown on id (if applicable) Surname Surname Gender Gender Male Date of birth Female Male (DD/MM/YYYY) Date of birth 1 Female (DD/MM/YYYY) Personal details (continued) Applicant 1 Applicant 2 Marital status Marital status Married/Civil partnership Widowed Single Separated Married/Civil partnership Divorced/Dissolved Civil partnership Widowed Has your name ever changed? Yes Single Has your name ever changed? No Yes No Previous first name Previous first name Previous middle name Previous middle name Previous surname Previous surname How many dependent children do you have? Nationality Nationality National Insurance Number National Insurance Number Dual Nationality Dual Nationality Country of residence Country of residence Do you have diplomatic immunity?* Do you have diplomatic immunity?* Yes No Yes No Work telephone number Work telephone number Home telephone number Home telephone number Mobile number Mobile number Preferred contact number Preferred contact number Work Home Mobile Work Home Home email address Home email address Work email address Work email address Special needs Special needs Large print Braille Audio text Large print Current address Braille Postcode Yes Mobile Audio text Current address Postcode Has your address changed in the last 3 years? Has your address changed in the last 3 years? No Yes Date moved into current address No Date moved into current address * TSB do not accept applications where the customer benefits from diplomatic immunity. 2 Separated Divorced/Dissolved Civil partnership Customer information Applicant 1 Customer type Applicant 2 Customer type First time buyer Home Mover Remortgage Existing TSB Borrower First time buyer Remortgage – own conveyancer Home Mover Will the existing mortgage be repaid within one month of completion? Yes Remortgage Existing TSB Borrower Remortgage – own conveyancer Will the existing mortgage be repaid within one month of completion? No Yes Residential status No Residential status Home owner – mortgage Renting Home owner (mortgage free) Home owner – mortgage Family/Friend Renting Home owner (mortgage free) First previous address in last 3 years Family/Friend First previous address in last 3 years Postcode Postcode Date moved into previous address Date moved into previous address Date moved out of previous address Date moved out of previous address Residential status Residential status Home owner – mortgage Renting Home owner (mortgage free) Home owner – mortgage Family/Friend Renting Home owner (mortgage free) Second previous address in last 3 years Family/Friend Second previous address in last 3 years Postcode Postcode Date moved into previous address Date moved into previous address Date moved out of previous address Date moved out of previous address Residential status Residential status Home owner – mortgage Renting Home owner (mortgage free) Home owner – mortgage Family/Friend Renting Home owner (mortgage free) Family/Friend Money laundering Was the verification taken? Face to face Was the verification taken? Non Face to face Face to face Non Face to face Applicant identification Applicant identification Applicant 1 Applicant 2 Type of standard verification provided Type of standard verification provided Document reference Document reference Date of issue Date of issue 3 Money laundering (continued) Applicant 1 Applicant 2 Issuing office/organisation Issuing office/organisation Type of secondary verification provided Type of secondary verification provided Document reference Document reference Date of issue Date of issue Issuing office/organisation Issuing office/organisation Employment details Applicant 1 Number of jobs per applicant Applicant 2 Number of jobs per applicant What type of occupation are you in? e.g. Sales, office, professional, trades What type of occupation are you in? e.g. Sales, office, professional, trades Employment type Employment type PAYE Self employed PAYE Contract type Permanent Self employed Contract type Probationary Seasonal/Temp Piecework Fixed/short term Sub-contract Permanent Agency Probationary Seasonal/Temp Fixed/short term Start date of employment Start date of employment Percentage of business owned Percentage of business owned % % Anticipated age of retirement Anticipated age of retirement Type of anticipated retirement annual income Type of anticipated retirement annual income Anticipated retirement annual income Anticipated retirement annual income £ £ Frequency of anticipated retirement annual income Frequency of anticipated retirement annual income Type of anticipated retirement annual income Type of anticipated retirement annual income Anticipated retirement annual income Anticipated retirement annual income £ £ Frequency of anticipated retirement annual income Frequency of anticipated retirement annual income 4 Employment details (continued) Applicant 1 Applicant 2 Name of employer/business Name of employer/business Employer’s/business address Employer’s/business address Postcode Postcode Employer’s/business telephone number Employer’s/business telephone number Employer’s/business fax number Employer’s/business fax number Do you have income from any other sources? Do you have income from any other sources? Yes No Yes No (If ‘Yes’, please complete the ‘Other Income’ section on page 7.) (If ‘Yes’, please complete the ‘Other Income’ section on page 7.) Income Basic annual income Income Basic annual income £ Can income be verified? Yes No Yes No £ Annual commission £ £ No Yes No Yes No Yes No Annual bonus Yes No £ Annual overtime £ Yes Annual commission Annual bonus £ Can income be verified? Annual overtime Yes No £ If self-employed Latest year Year end date If self-employed Latest year Year end date Turnover (£) Turnover (£) £ £ Gross profit (£) Gross profit (£) £ £ Net profit (£) Net profit (£) £ £ Assets (£) Assets (£) £ £ Liabilities (£) Liabilities (£) £ £ Previous year Year end date Previous year Year end date Turnover (£) Turnover (£) £ £ Gross profit (£) Gross profit (£) £ £ 5 Employment details (continued) Applicant 1 Applicant 2 Net profit (£) Net profit (£) £ £ Assets (£) Assets (£) £ £ Liabilities (£) Liabilities (£) £ £ 2nd previous year Year end date 2nd previous year Year end date Turnover (£) Turnover (£) £ £ Gross profit (£) Gross profit (£) £ £ Net profit (£) Net profit (£) £ £ Assets (£) Assets (£) £ £ Liabilities (£) Liabilities (£) £ £ Projected year Year end date Projected year Year end date Turnover (£) Turnover (£) £ £ Gross profit (£) Gross profit (£) £ £ Net profit (£) Net profit (£) £ £ Assets (£) Assets (£) £ £ Liabilities (£) Liabilities (£) £ £ What year did you acquire an interest in the business? What year did you acquire an interest in the business? In what year was the business established? In what year was the business established? Does the business have accounts? Does the business have accounts? Yes No Yes No Name of accountant’s firm Name of accountant’s firm Accountant’s address Accountant’s address Postcode Postcode 6 Employment details (continued) Applicant 1 Applicant 2 Accountant’s telephone number Accountant’s telephone number Name of previous employer/business Name of previous employer/business Previous employer’s/business address Previous employer’s/business address Postcode Postcode Previous employer’s/business telephone number Previous employer’s/business telephone number Previous employer’s/business fax number Previous employer’s/business fax number What type of employment was this? e.g. Sales, office, professional, trades What type of employment was this? e.g. Sales, office, professional, trades Start date of employment Start date of employment End date of employment End date of employment (If total employment history is still less than 18 months, please complete section 2 on page 15.) Other income Applicant 1 Applicant 2 What type of income is this? What type of income is this? Annual amount (£) Annual amount (£) £ £ What type of income is this? What type of income is this? Annual amount (£) Annual amount (£) £ £ Scheme(s) required Right to buy Second home loan Shared equity Shared Ownership Shared equity What equity stake will be held by the customer? Shared ownership What percentage share will be purchased? % % Monthly interest payments Monthly rental commitments £ £ Name of shared ownership company 7 Loan details Purchase price/valuation £ Market value (right to buy) £ Cost of improvements £ Loan amount £ Total value of cash incentives £ Builder/Seller Concessionary Savings Tenants Incentive Scheme Equity Gift Homebuy Housing Assoc or RSL Loan None Loan details Provide breakdown of the mortgage required. Parts 2 and 3 are where multiple products, terms or repayment types are required. Part 1 Part 2 Part 3 Product code (if known) Product code (if known) Product code (if known) Type of product e.g. fixed, tracker Type of product e.g. fixed, tracker Type of product e.g. fixed, tracker Interest rate charged Interest rate charged Interest rate charged Product term/end date Product term/end date Product term/end date Loan amount Loan amount Loan amount £ £ £ Loan term (years) Loan term (years) Loan term (years) Repayment type Repayment type Repayment type Purpose Purpose Purpose What is your preferred payment date? 8 Product details (continued) Interest only amount Give details of new or existing plans or policies to be used with the interest only part of this mortgage. Endowments £ Sale of other residential property – Unit Trusts/ Open Ended Investment Companies (UK) Stocks & Shares ISA Investment Bonds Stocks & Shares Pensions Please also complete Interest only – Other residential property form for each property. Total £ £ £ £ £ £ £ £ £ £ £ £ £ £ Monthly premium £ Reference/Account number Maturity date for each repayment vehicle Personal finances (both applicants) Time with bank Applicant 1 Years Applicant 2 Years Months Months Credit commitments (These include finance commitments like credit cards, charge cards, store cards, overdrafts, loans, hire purchase payments, mail order, and buy now pay later arrangements. They also include commitments like child maintenance payments, student loan repayments, child care costs, school or university fees and any significant hobby costs that the applicant does not wish to stop.) Type of commitment Commitment 1 Commitment 2 Commitment 3 Commitment 4 Commitment 5 Whose name is commitment in? Name of lender/company Monthly repayment £ £ £ £ £ £ £ £ £ D D M M Y Y Y Y D D M M Y Y Y Y D D M M Y Y Y Y D D M M Y Y Y Y Balance outstanding £ End date of loan D D M M Y Y Y Y Number of months in arrears Will this be repaid on completion in full? Yes No Yes No Yes No If yes, source of funds to repay Total monthly maintenance payments £ 9 Yes No Yes No Personal finances (both applicants) (continued) For mortgage commitments only, complete the information below: Mortgage type Remaining term Repayment type Name of lender/company Monthly repayment £ Balance outstanding £ End date of loan Current months in arrears Intend to repay on completion Yes No Source of repayment Second home monthly running costs £ If you have additional mortgage commitments complete section 3 on page 15. Have any future known changes to income/expenditure been taken into account? Yes No Financial history Has any applicant been in arrears in the last 6 years with any borrowing or ever had a property repossessed? Yes No Has any applicant had a County Court judgment (CCJ) or default registered against them or if self-employed against their business within the last 6 years? Yes No Has any applicant been declared bankrupt, entered into an IVA or debt relief order within the last 6 years or still have an outstanding bankruptcy restriction order? Yes No Property information Postal address of the property Postcode Property What type of property is this? House Bungalow Converted flat Purpose built flat Detached Semi detached End terrace Mid terrace No of bedrooms If the property is a flat, number of floors in the block 10 Other Property information (continued) Which floor is the flat on? Purchase type Normal Sitting tenant Inheritance Gift Other Local authority Was the property built in the last 12 months? Yes No Year property built Property to be occupied for the first time in its current state? Yes No Builder’s name If a new property is being purchased, please confirm the building standards indemnity scheme NHBC Zurich Municipal Consultant Monitored Premier Guarantee/Liberty Legal Building Lifeplans/Allianz Global Risks CRL LABC New Homes Warranty LABC Hallmark Warranty Buildzone Other None Investment Club Normal Local Authority New Town Corporation Housing Assoc. The Coal Authority Builder/developer TSB selling as possessor Who is selling the property ? Name Do you currently own the property? Yes No Do you currently live at the property? Yes No Will anyone else (aged 17 or over) live at the property? Yes No Occupation within 12 months All Part None Will business be carried out at this property? Yes No Legal title What is the tenure of the property? Freehold Leasehold Common hold Ownership Interest Remaining term of lease (if leasehold) How much will the following be? (if applicable) Annual ground rent £ Annual service charge Annual chief rent or feu duty (Scotland) £ £ Entry date – Scotland only Type of initial occupancy property New build Refurbishment Conversion 11 Remortgage details (only to be completed for remortgage applications) Original purchase price £ Lender’s name Mortgage account number Outstanding mortgage amount £ Please provide details of any improvements you have made to the property (including estimated costs) Has your home or nearby building been damaged by subsidence, heave, landslip or does it show any signs of cracking or bulging of walls? Yes No Accommodation Please provide the following details about the property Number of bedrooms Number of bathrooms Number of living rooms Number of separate toilets Number of habitable rooms Does the property have: Central heating Full Part None Electricity Oil Central heating type Gas Solid Fuel A conservatory Yes No How many cars can be garaged? Off road parking Yes No A garden Yes No No. of acres Road charge liability Is there any other secured lending on the property? Yes No Reason for remortgage Remortgage only Remortgage & home improvements Remortgage & debt consolidation Other Remortgage home improvements & debt consolidation 12 Other Other secured lending Name of lender Loan 1 Loan 2 Loan 3 Account number To be repaid or postponed Repaid Postponed Repaid Postponed Repaid Postponed No Yes No Customer advised if deed of postponement or ranking agreement needed Yes No Yes Other occupants Please give the names of anybody aged seventeen or over and not party to the mortgage who will live at the property. Forename(s) Surname Forename(s) Surname Valuation details Valuation type Valuation Survey and Valuation Building Survey and Valuation Access to the property The keys can be obtained from: Name Telephone number Evening telephone number Selling agent (if different) Selling agent’s telephone number Extension Other contact details 13 Remortgage Valuation Conveyancer’s details Are you using your own conveyancer? Yes No Name of firm Address Postcode Who is acting for you? Telephone number Fax number Supporting information If you want to provide any additional information to support your application, please use the section below. Section 1 Additional information on previous addresses 14 Supporting information (continued) Section 2 Additional information on current/previous employers Section 3 Additional information on mortgage commitments Mortgage type Remaining term Repayment type Mortgage lender Monthly running cost £ Monthly payment £ Outstanding balance £ End date Current months in arrears Intend to repay on completion Yes No Source of repayment 15 Supporting information (continued) Section 4 Any other information you feel we might need to know to help us assess your application for a mortgage, in particular, if the loan extends beyond retirement age. Please confirm how you intend to maintain payments. 16 Easy ways to make your payments For your convenience monthly payments will be made from a bank/building society using direct debit. Please complete the section below. Payment mandate Instructions to your bank or building society to pay direct debits Originator’s Identification Number 8 8 3 0 0 8 To: The Manager Bank or Building Society Address Postcode Please pay TSB Direct Debits from the account detailed on this Instruction subject to the safeguards assured by The Direct Debit Guarantee. I understand that this instruction may remain with TSB and, if so, details will be passed electronically to my Bank/Building Society. Signature(s)Date Name of account holder(s) Bank or Building Society account number Branch sort code TSB Bank plc reference number Banks and Building Societies may not accept Direct Debit Instructions for some types of accounts. ! Please retain this section for your information The Direct Debit Guarantee – this should be retained • This Guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme. The efficiency and security of the scheme is monitored and protected by your own Bank or Building Society. • If the amounts to be paid or the payment dates change, TSB will notify you 10 working days in advance of your account being debited or as otherwise agreed. • If an error is made by TSB Bank plc, or your Bank or Building Society, you are guaranteed a full and immediate refund from your branch of the amount paid. • You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us. 17 THIS PAGE SHOULD BE READ AND RETAINED BY ALL CUSTOMERS Customer confirmation If I apply for a mortgage I confirm that I make the following statements: I declare that:1. I apply for a loan on the security of the property described in this application; 2. I believe the information given in this application is correct. I authorise you to:3. Make any enquiries of any third parties for reference purposes and for the third party to disclose any information to you; 4. Change the address on all my accounts held with you. I agree that:5. I will notify you of any changes in circumstances relating to my purchase or mortgage before it is entered into and I authorise my conveyancer to disclose such information to you; 6. Where I am making this application with one other joint applicant (but not more than one other), following completion you may act on the request of either of us for a payment arrangement, payment holiday or the release of any retained funds or drawdown of reserve/credit available under the mortgage. I also agree that such a request may be made in person, in writing, by telephone or online. 7. If I borrow and do not repay in full and on time, you may tell credit reference agencies who will record the outstanding debt and my details may be submitted to the Council of Mortgage Lenders possessions register; 8. I have received information explaining property assessments. I understand that:9. The payment of any fees is non-refundable and shall not mean that you have to make an advance; 10.If I/we choose a Homebuyers Survey and Valuation Report, you will choose the valuer for the property assessment and that it is the valuer’s responsibility to agree the Conditions of Engagement for the private survey element with me; Data protection notice Your information will be held by TSB Bank plc. More information can be found at tsb.co.uk We will share your personal information from your application with fraud prevention agencies. If false or inaccurate information is provided and fraud is identified, details of this fraud will be passed to these agencies to prevent fraud and money laundering. Further details explaining how information held by the fraud prevention agencies may be used can be obtained by reading the privacy notice at tsb.co.uk or contacting your local branch. We may obtain information about you from credit reference agencies, fraud prevention agencies, and Group records to check your credit status and identity. The agencies will record our enquiries which may be seen by other companies who make their own credit enquiries. This may affect your ability to obtain credit elsewhere in the near future. We may also use credit scoring. Your application will be assessed using credit reference agency records relating to you and anyone with whom you have a joint account or similar financial association. If this is a joint application and such a link does not already exist then one may be created now. These links will remain until you successfully apply for a “notice of disassociation” at the credit reference agencies. If you are providing information on behalf of a joint applicant, by continuing with this application you confirm that you have their permission to do so and they have agreed that we are authorised to search, link and record information about them at credit reference agencies. We may ask you to provide physical forms of identity verification when you open your account. Alternatively, we may search credit reference agency files in assessing your application. The agency also gives us other details and information from the Electoral Register to verify your identity. The agency keeps a record of our search, whether or not your application proceeds. Our search is not seen or used by lenders to assess your ability to obtain credit. Under the Data Protection Act you have the right of access to your personal data. The Act allows us to charge a fee of £10 for this service. If anything is inaccurate or incorrect, please let us know and we will correct it. TSB may use your information to contact you by mail, telephone, email or text message about products and services that may be of interest to you. If you do not wish to receive this information please contact your local branch or visit tsb.co.uk for details of how to opt out of this service. It is important that you understand how the personal information you give us will be used. Therefore, we strongly advise that you read our Privacy Statement, which you can find at tsb.co.uk or you can ask us for a copy. By applying for a mortgage, you agree to your personal information being used in the ways we describe in our Privacy Statement. Please let us know if you have any questions about the use of your personal information. 18 Remortgage customer authority (where applicable) 1. I authorise you or any conveyancers acting for you in connection with the proposed remortgage of my property: • to obtain the title deeds to the property; • to obtain a repayment figure from my/our current lender(s). 2. I confirm that I will make my own enquiries about and pay any fees or charges made by my current lender in connection with the repayment of my existing mortgage (including any administration fees made in respect of sending the title deeds to your conveyancer and providing a repayment figure and any fees in connection with my existing mortgage). 3. I understand that your conveyancer is only representing you and that if I want independent legal advice at any stage of this transaction I will obtain and get it myself. 4. I understand that you may not arrange for an inspection of the property to be carried out. I further understand that you will not routinely tell me what your assessment of the value of the property is. I understand that, if you are prepared to make me a loan, I must not rely upon any assessment made as an indication of the value of the property. You have informed me and I accept that, if I require any information about the value or condition of the property or about any health and safety issues, it is my responsibility to obtain independent advice before I go ahead with the remortgage of the property. Land registry I authorise your conveyancer to obtain copies of any document held at any of the land registries in England and Wales and Scotland. 19 If you’d like this in another format such as large print, Braille or audio please contact your Business Development Manager. Important information. You must be at least 18 years old to take out a loan with us. Before agreeing a loan we will want to satisfy ourselves about the suitability of your application, which will include assessing your ability to afford the payments and, normally, valuing the property. Calls may be monitored or recorded. If you need to call us from abroad, or prefer not to use our 0345 number, you can also call us on 0203 384 1575. Not all Telephone Banking services are available 24 hours a day, seven days a week. Please speak to an adviser for more information. TSB Bank plc. Registered Office: Henry Duncan House, 120 George Street, Edinburgh EH2 4LH. Registered in Scotland no. SC95237. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority under registration number 191240. TSB Bank plc is covered by the Financial Services Compensation Scheme and the Financial Ombudsman Service. TSB10499 (03/15) FSC Logo Area
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