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APPLICANT 1
Full Name
Home Telephone
Work Telephone
Mobile Telephone
Email
Date of Birth

APPLICANT 2
Full Name
Home Telephone
Work Telephone
Mobile Telephone
Email
Date of Birth

Loan Requirement	Amount £
Term Required	years
Type of Loan	Purchase Remortgage Are you a First time buyer? Buy to Let / Investment Property Other
Purchase price or Property Value of property being purchased or remortgaged	Amount £
Purpose of additional borrowing, if remortgage
Monthly rental being received on property to be remortgaged	Amount £
Monthly rental anticipated on property to be purchased	Amount £
Mortgage outstanding on property to be mortgaged (if applicable)	Amount £
Monthly mortgage or rent payment	Amount £
Current Lender or Landlord Name

CREDIT - APPLICANT 1
Have you any arrears on your current mortgage/rent	Yes No
If yes, how many months in arrears ?	Months
	Amount £
Have you any CCJ's ?	Yes No
If yes, please give details
1. £	Date
2. £	Date
3. £	Date
4. £	Date
5. £	Date
Have you ever been declared bankrupt?	Yes No
If so, when ?	Date of discharge
Have you ever entered in to an Individual Voluntary Arrangement (IVA)	Yes No
If so, when ?	Conducted satisfactorily ? Yes No
Date of discharge

CREDIT - APPLICANT 2
Have you any arrears on your current mortgage/rent	Yes No
If yes, how many months in arrears ?	Months
	Amount £
Have you any CCJ's ?	Yes No
If yes, please give details
1. £	Date
2. £	Date
3. £	Date
4. £	Date
5. £	Date
Have you ever been declared bankrupt?	Yes No
If so, when ?	Date of discharge
Have you ever entered in to an Individual Voluntary Arrangement (IVA)	Yes No
If so, when ?	Conducted satisfactorily ? Yes No
Date of discharge

Additional Information
Any additional information you would like to provide that you feel will help in your application process

Rates from 3.39%. The overall cost for comparison is 4.3% APR. APR variable and based on an usual case. The actual rate available will depend on your circumstances. Ask for a personalised illustration.

THINK CAREFULLY BEFORE SECURING OTHER DEBTS AGAINST YOUR HOME. YOUR HOME MAY BE REPOSSESSED IF YOU DO NOT KEEP UP REPAYMENTS ON A MORTGAGE OR ANY OTHER DEBT SECURED ON IT.

Pavillion is a trading style of Pavillion Securities Ltd registered in England and Wales 03031149 Consumer Credit Licence 392683 Authorised and regulated by the Financial Services Authority 302763 (not all forms of mortgage are regulated by the Financial Services Authority)