First Commercial Funding

Applicant

Introductory Agent (if applicable)

A. What is the purpose of the mortgage?

B. How much does the Applicant want to borrow?

£ Over Years

C. What security is offered for the advance?

Address:
Freehold/lease:
If leasehold, years unexpired:
Current market value:

D. Is the property or business to be purchased by Applicant? If so, please complete the following:

Purchase price:
Applicant's contribution:
Source of applicant's contribution:
Does purchase price include goodwill, fixtures and fittings?	Yes No

If the answer to question 'A' is 'refinance', please complete the following:

Is the applicant's ability to service the borrowing to be evidenced by:

Other:

Is there any further information that may help us?

Additional securities (type, value) :
Additional income (amount, source):

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