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Mortgage Brokers in South Wales - Greg Roberts & Co
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Your Loan Requirement
Purpose Of Loan 
Loan Amount
£
Your Personal Details
First Applicant
Second Applicant (If Applicable)
UK Resident
 
Are you on the Electoral Role?
Title
First Name
Middle Name
Surname
Date of Birth
Status
Gross Income(pa)
Employment
If Self Employed Fill in The Section Below....
Occupation
Business Title
Business Address
(If different from below)
Postcode
Net Profit (£)
Chartered Accounts
Period of Self Employment
Years Months
Self Cert. of Income
Time at Current Address  
Years Months
Years Months
Your House & Contact Details
Current Address
Old Address (If less than 3 years at Current Address)
Home Address 
(Contd.) 
Town/City 
County 
Post Code 
Home Phone 
Work Phone 
Mobile 
E-mail 
Property Details
Number of Bedrooms
Number of Floors
Property Type
Tenure
Approx Year Built
Number of Reception Rooms
Number of Bathrooms
Garage
Your Mortgage Details - For Mortgage Payers & Homeowners Only
Name of Lender 
Monthly Payment 
£
Mortgage Amount 
£
Approx. Property Value 
£
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Greg Roberts & Co © 2008 • all rights reserved
 
Listed on UFindUs for Mortgages

The Financial Conduct Authority does not regulate some aspects of commercial mortgages, buy to let mortgages and loans
We are entered on the FSA Register No 312828 at www.fsa.gov.uk/register

Consumer Credit Licence # 631501.

The guidance and/or advice contained within the website is subject to the UK regulatory regime and is therefore primarily targeted at customers in the UK

YOUR HOME OR PROPERTY MAY BE REPOSSESSED IF YOU DO NOT KEEP UP REPAYMENTS ON A MORTGAGE OR OTHER DEBT SECURED ON IT

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