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					                                                                                                                                              Information acquisition


Future Mortgages is the trading name of Future Mortgages Ltd. Registered in England and Wales. Registration No. 3300794.
Registered Office: 87 Castle Street, Reading RG1 7DX.

                                                                                                                           FM AP001 (10/04)
Unpackaged Case Submission Checklist                                                                                           If you are a professional mortgage adviser please note:
                                                                                                                               This mortgage will not be processed unless the following sections on pages 3 and 4 are fully completed.
                                                                                                                               Future Mortgages will only accept applications from an intermediary who is FSA registered and holds a
Please ensure that the following documentation is provided, where applicable
                                                                                                                               valid Consumer Credit Licence

        Fully completed application form. Please ensure that any additional information requested
        is included in Section J.
                                                                                                                              Business Description (please tick the appropriate box)

        Cheque for appropriate application fee or completion of Section Li/Lii.
                                                                                                                              Directly Authorised
        Each applicants’ last 3 months computerised pay slips and P60 (Status cases only).
                                                                                                                              Appointed Representative
        If these are not available an employment reference will be requested.
                                                                                                                              Other                                              Please specify
        Proof of the last 12 months mortgage payments (i.e. last annual mortgage statement with
        up to date bank statements). If this is not available then a lenders reference will be requested.
        For Buy to Let re-mortgages proof of mortgage payments will be required for both the residential                      Nominated Scheme/National Account Details
        and Buy to Let properties.

                                                                                                                              Scheme Name
        Certified or original proof of ID required for each applicant.
                                                                                                                              If you have a sticker
                                                                                                                              affix here
        Certified bank statement or utility bill for each applicant dated within the last 3 months at current
        residential address.

        Certified proof of residency covering 24 months if applicants are not registered on voters roll.

        Proof of rent payments for the last 12 months and original/certified copy of the Section 125
        if application is for a Right to Buy Mortgage.

        Discharge certificate if previously bankrupt.

        Foreign Nationals only – if applicant has a right to reside, confirmation is required.                                 Future Mortgages Use Only
        Please provide the original documentation from the Home Office or original passport.
                                                                                                                               Date Received                                                          Consultant Code
        Proof of deposit – normally required in cases where the deposit is in excess of £10,000.
        This is to comply with Money Laundering regulations.                                                                   Applicants Name                                                        M.I.P.S ID Number

Notes to Application Form                                                                                                     Please send the completed form to:
                                                                                                                              New Business
1. Please use black ink and block capitals throughout                                                                         Future Mortgages Ltd
2. Please ensure you answer all questions, if a question is not applicable write in N/A                                       6 Admiral Way
3. Return the application form together with:                                                                                 Doxford International Business Park
   – a cheque made payable to Future Mortgages Ltd to cover the application/booking fee, or if paying by credit/debit card,   Sunderland
   please ensure Li/Lii is completed and signed where applicable                                                              SR3 3XW
4. Remember to complete the Direct Debit section and sign the declaration                                                     DX 715946 Sunderland-Doxford
5. If you wish to discuss any aspect of the application, either before or during processing, please telephone on;
   08457 388 873 or e-mail                                                                       Disability Discrimination Act
6. This application form may be used for Regulated Mortgage Contracts and Non Regulated Buy To Lets                           In accordance with the Disability Discrimination Act 1995 we are able to provide upon request a TextPhone facility, audio tapes,
                                                                                                                              large print documentation and Braille documentation.
                                                                                                                              Please contact us on 0800 015 6653 if you require any of these services to be provided so that we can communicate in an appropriate manner.

    Details of Intermediary – To be completed in all cases                                                                                                Section A – Details of Applicants
                                                                                                                                                                                     First Applicant                                                           Second Applicant

    Company Name                                                                                              A1   Title                                      Mr                         Mrs                           Miss                Mr                        Mrs                            Miss

                                                                                                                                                              Other (specify)                                                              Other (specify)
    Contact Name                                                                                              A2   Surname

                                                                                                              A3   Maiden name
    Director’s Name
                                                                                                              A4 First names

    Company Address                                                                                           A5 Date of Birth

                                                                                                              A6 Status                                       Married                 Single                Separated                      Married                 Single               Separated

                                                                                                                                                              Widowed                 Divorced                                             Widowed                 Divorced
                                                                                                              A7   Total number of dependents
                                                                        Postcode:                                  in household
                                                                                                              A8 Relationship to joint
                                                                                                                 applicant (if applicable)
                                  Phone No:                             Fax No:
                                                                                                              A9 Are you a UK tax payer?
                                                                                                                   (If no give details in Section J)
                                                                                                                                                              Yes                        No                                                Yes                       No

                                  FSA Number/AR Reference:              CCL No:
                                                                                                              A10 National Insurance No:

                                 E-mail address:                                                              A11 Present address
                                                                                                                   (If you own more than one
                                                                                                                   residential property please
                                                                                                                   give details in Section J)
                                                                                                                                                                                           Postcode                                                                    Postcode

                                                                                                                   Tenure of previous address                 Owner                   Tenant                With relatives                 Owner                   Tenant               With relatives
    Details of Packager (where applicable)                                                                                                                 Home                                                                        Home
                                                                                                              A12 Telephone no.
                                                                                                                                                           Work                                                                        Work
                                                                                                                                                           Mobile                                                                      Mobile
    Company Name
                                                                                                              A13 How long have you been at
                                                                                                                                                                                           years                              months                                   years                               months
                                                                                                                  your present address?
    Contact Name
                                                                                                              A14 If less than 3 years at your
                                                                                                                  present address give
                                                                                                                  previous addresses
    FSA No. (where applicable)                                                                                     (continue in Section J if necessary)                                    Postcode                                                                    Postcode

                                                                                                                   Tenure of previous address                 Owner                   Tenant                With relatives                 Owner                   Tenant               With relatives
                                                                                                              A15 How long were you at your
                                                                                                                                                                                           years                              months                                   years                               months
                                                                                                                  previous address
    Details of National Accounts – To be completed where intermediary is associated with a National Account        (continue in Section J if necessary)
                                                                                                                                                          If your correspondence address is other than your present address or the property to be mortgaged please
                                                                                                                                                          provide details and reason in the Additional Information section
                                                                                                              A16 Have you been party to a
                                                                                                                  mortgage or secured loan                    Yes                     No                                                   Yes                     No
    Company Name                                                                                                  within the past 2 years?
                                                                                                                   (if yes please complete section C)

                                                                                                              A17 Are you a first time buyer?                 Yes                     No                                                   Yes                     No
    Contact Name                                                                                              A18 Have you had any County                     Yes                     No           (Decree in Scotland)                    Yes                     No           (Decree in Scotland)
                                                                                                                  Court Judgements
                                                                                                                  registered in your name?*
    FSA No. (where applicable)                                                                                A19 Have you at any time in the                 Yes                     No                                                   Yes                     No
                                                                                                                  last 2 years been in arrears
                                                                                                                  with any mortgage or
                                                                                                                  secured loan payments?*
                                                                                                              A20 Have you ever been                          Yes                     No           If Yes, Date of Discharge               Yes                     No           If Yes, Date of Discharge
    Intermediary use only (KFI Information – RMCs only)                                                           insolvent or bankrupt?*

                                                                                                              A21 Have you ever had a
                                                                                                                                                              Yes                     No           If Yes, Date of Repossession            Yes                     No           If Yes, Date of Repossession
                                                                                                                  property repossessed?*
    I.   KFI issuer (systems)
                                                                                                              A22 Have you ever entered into
                                                                                                                                                              Yes                     No                                                   Yes                     No
                                                                                                                  an Individual Voluntary
    II. KFI Reference Number                                                                                      Arrangement?*
                                                                                                              A23 Are you party to any other
                                                                                                                                                              Yes                     No                                                   Yes                     No
    III. Level of Service        Advice         Information Only                                                  mortgage or do you own any
                                                                                                                  other property?*
                                                                                                              A24 Have the DSS paid all or
                                                                                                                                                              Yes                     No                                                   Yes                     No
    IV. I confirm that an IDD has been issued                                                                     part of your mortgage/rent
                                                                                                                  payments in the last                    *If you have answered YES to any questions from A16 to A23                   *If you have answered YES to any questions from A16 to A23
                                                                                                                  12 months?*                              please provide details in Section J                                          please provide details in Section J
4                                                                                                                                                                                                                                                                                                                   5
                                               All applicants (including those using Self Declaration of Income) must complete Section B as appropriate
                                                                                                                                                                                                                            Section Bii – Income Details (self-employed) continued
                                               Section Bi – Income Details (Employees)                                                                                                                                      Partners or Controlling Directors holding 25% or more of Company Issued Shares, Schedule D Taxpayers and Sole Traders

                                                                       First Applicant                                                   Second Applicant                                                                                               First Applicant                                                               Second Applicant

                                                 £                                                                  £
    B1   Basic salary p.a.                                                                                                                                                          B23 Name of accountant

    B2 Regular overtime/bonus/                   £                                                                  £
                                                                                                                                                                                    B24 Qualifications of
       commission p.a.                                                                                                                                                                  accountant
    B3 Other income p.a.                         £                                                                  £
                                                                                                                                                                                    B25 Address of accountant
                                                                                                                                                                                         (If the accountant is not
    B4 Source of other income                                                                                                                                                            chartered or certified we
         (Please give full details                                                                                                                                                       will require additional
         in Section J)                                                                                                                                                                   validation of income)                                               Postcode                                                                         Postcode

    B5 Occupation/job title                                                                                                                                                                                                   Tel No.                        Fax No.                                          Tel No.                         Fax No.

    B6 Status                                        Permanent         Temporary             Contract                   Permanent          Temporary            Contract

    B7 Are you on probation?
                                                                                                                                                                                                                            Section Biii – Income Details (self-certification)
                                                     Yes               No      Expiry date                              Yes                No     Expiry date
                                                                                                                                                                                                                             If you are self certifying any part of your income, please complete the following, in addition to section Bi or Bii
    B8 Employer’s name
    B9 Employer’s address                                                                                                                                                                                                                               First Applicant                                                               Second Applicant

                                                                                                                                                                                    B26 Amount of income to
                                                                                                                                                                                                                              £                                                                               £
                                                                                                                                                                                        be self-certified
                                                                            Postcode                                                            Postcode
    B10 Employer’s telephone &
                                                 Tel                                Fax                             Tel                                 Fax
        fax number                                                                                                                                                                                                           Signature                                                                       Signature

    B11 Length of service                                                                                                                                                                                                    Date                                                                            Date
                                                                            years                       months                                  years                      months
         (If less than 3 years complete B13)
                                                                                                                                                                                                                             I confirm that this is a true reflection of my income.                          I confirm that this is a true reflection of my income.
    B12 Payroll/personnel/                                                                                                                                                                                                   (Please note it is an offence to knowingly enter a false statement about        (Please note it is an offence to knowingly enter a false statement about
        employee no:                                                                                                                                                                                                         your level of of income, the penalty for which may include a prison             your level of of income, the penalty for which may include a prison
                                                                                                                                                                                                                             sentence.)                                                                      sentence.)
    B13 Previous employer’s
        name and address
                                                                                                                                                                                                                            Section C – Details of Existing Loans and Commitments (including Mortgages)
                                                                                                                                                                                                                            Please give details of all your loans. This should include any existing mortgages. Please continue in the Additional Information Section J.
                                                                            Postcode                                                            Postcode                                                                    Think carefully before securing other debts against your home. Your home may be repossessed if you do not keep up repayments on your mortgage.

    B14 Length of service                                                   years                       months                                  years                      months                                                                                                                                                                     Is it a loan
                                                                                                                                                                                              1st App                                                                            Purpose                                Monthly         Balance                    To be repaid
         (If the above employment details                                                                                                                                                                             Start Date                Lender                                                   Term                                      secured against
                                                                                                                                                                                              2nd App                                                                            of Loan                                Payment        Outstanding                   Yes/No
         do not equate to 3 years service,                                                                                                                                                                                                                                                                                                           a property?
         please continue in section J)         Section Bii – Income Details (self-employed)
                                               Partners or Controlling Directors holding 25% or more of Company Issued Shares, Schedule D Taxpayers and Sole Traders

                                                                       First Applicant                                                   Second Applicant

    B15 Name of firm/company

    B16 Address of firm/company

                                                                            Postcode                                                            Postcode

                                                                            years                       months                                  years                      months                                                                                                                           Total
    B17 How long has the business
        been trading?
                                                                            years                       months                                  years                      months   C1   For any secured loans:
    B18 How long have you                                                                                                                                                                (Please complete the following                                 First Applicant                                                               Second Applicant
        been involved with                                                                                                                                                               and continue in Section J if
        the business?                                                                                                                                                                    necessary)

                                                                                                                                                                                         Existing Lender’s name
    B19 Company registration no.                                                                                                                                                         and address details
         (if applicable)                                                                                                                                                                 (minimum 12 months history
    B20 Nature or type of business                                                                                                                                                                                                                           Postcode                                                                         Postcode

    B21 % of issued shares held
                                                                                                                                                                                                                                                                      Tel. no.                                                                      Tel. no.
         (if applicable)                                                                                                                                                                 Account No.
                                                 Year:                              £                               Year:                               £
    B22 Net profit for the last
        3 years                                                                                                                                                                          Address of Property
                                                 Year:                              £                               Year:                               £
                                                                                                                                                                                         (If different from current
                                                                                                                                                                                         residential address)
                                                 Year:                              £                               Year:                               £
                                                                                                                                                                                                                                                             Postcode                                                                         Postcode

6                                                                                                                                                                                                                                                                                                                                                                                       7
                                           Section D – Details of Mortgage Required                                                                                                                              Section D – Details of Mortgage Required (continued)

    D1    Mortgage product                                                                                                                                                                                                      Description of Fee                 Fee         Payable at which stage                   Payable to Whom            Refundable If Yes    Estimated?
          selected                                                                                                                                                            D15 Please indicate any                                                                             (Tick applicable stage)
                                                                                                                                                                                                                                                                 Amount £                                                                              Y/N    to what       Y/N
                                                                                                                                                                                  additional fees (not                                                                          App.     Offer       Comp.                                                     extent
    D2    Amount of loan required                                                                                                                                                 payable to Future
                                                                                                                                                                                  Mortgages Ltd) which may
          (If Part Interest Only/Part       £                                      £                                                                                              be payable in connection
          Capital Repayment please                                 Interest Only                    Capital Repayment                                                             with this mortgage (You
          identify split)                                                                                                                                                         may have to pay other
          What is the interest rate                           %                                                                                                                   taxes or costs in addition
          of the loan?                                                                                                                                                            to any fees shown here)
          What type of interest rate            LIBOR             Fixed      Discounted        Stepped                                              Other
          has been agreed?                                                                                                                                                                                       Section E – Property to be Mortgaged
    D3    Repayment method                      Capital Repayment                  Interest Only*          Part Capital Repayment/Part Interest Only                          E1    Address of property to be
                                           *If you have chosen to repay some or the entire mortgage on an Interest Only basis, you will need to ensure that you have a              mortgaged
                                           separate savings plan in place to build up a lump sum to repay the amount borrowed on this basis. Remember you can seek
                                           independent legal and financial advice if you are in doubt about this mortgage.                                                                                                                                                                                                                        Postcode

                                            Company Name                                                                                                                                                                                                                                                yrs                                   £
          If Interest Only or Part                                                                                                                                            E2    Tenure                              Freehold            Leasehold                Feudal (Scotland only)                   Unexpired term (if leasehold)            Ground rent (if leasehold)
          Interest please complete
          the following section                                                                                                                                               E3    Type                                Detached              Semi          Terraced             End of Terrace                Bungalow         Flat        Maisonette
                                           Repayment Vehicles             PEP          ISA     Endowment        Pension          Unit Trust Investments
          regarding your chosen
          Repayment Vehicle if              Policy Holder 1                                                    Policy Holder 2                                                E4    If flat/maisonette                  Purpose Built                Conversion
                                            Policy/Reference Number                                            Monthly Subscription Amount £                                        No. of floors in block

                                            Subscription Frequency                                             Term                                         (if applicable)         Is it above commercial              Yes                                No
                                            Start date                                                         End date                                     (if applicable)
                                                                                                                                                                              E5    Construction of                     Brick                              Other – specify
                                           If multiple please add in Additional Information Section                                                                                 external walls

                                                                                                                                                                              E6    Construction of roof                Tiles                              Other – specify
    D4    Is/was this a Right to Buy?           Yes                          No                                                         Date of purchase
          (If yes, please provide           Name                                                                                                                              E7    No. of rooms                           Bedrooms                   Living Rooms                     Kitchens               Bathrooms             W.C.s
          Local Authority details)
                                            Address                                                                                                                           E8    Year of construction                               New build*            If less than 10 years old does it have?                       NHBC             Architect’s certificate
                                                                                                                                                                                                                 (If yes, a £50 re-inspection fee will be charged)
                                            Reference Number

                                            £                                                                                                                                 E9    Name and address of
    D5    Amount of additional                                                                                                                                                      estate agent/contact
          capital being raised                                                                                                                                                                                                                                                                                                                    Postcode
                                                                                                                                                                                    for access
          (re-mortgage only)
                                                                                                                                                                                                                  Telephone No.
    D6    Purpose of Remortgage

                                                No extra money raised                                 Extra money raised for home improvements                                E10 Name of vendor

                                                Extra money raised for debt consolidation             Extra money raised for home improvements and debt consolidation                                             Telephone No.

                                            £                                                                                                                                 E11   Is there any relationship
    D7    Purchase price
                                                                                                                                                                                    (business, family,                  Yes                                No               Nature of relationship
                                            £                                                                                                                                       personal) between you
    D8    Value of deposit
    D9    Source of deposit                                                                                                                                                         and the vendor or you
          (If not from equity                                                                                                                                                       and the introducer?
          or own savings)                                                                                                                                                           If yes, are you benefiting          Yes                                No
                                                                                                                                                                                    from any special
    D10 Term (years)                                                                                                                                                                considerations/
    D11   Are other funds being                                                                                                                                                     deed of gift
          borrowed to assist in the             Yes                          No                                                                                               E12 Are improvements to be                Yes                                No
          purchase of this                                                                                                                                                        made?**
                                            £                                                                                                                                 E13 Will you let the property             Yes                                No
          If Yes, give amount                                                                                                                                                     to a family member?            *A family member is defined as any of the following: Your spouse, parents, grandparents, siblings, children, grandchildren,
                                            £                                                                                                                                     (*For the definition of        common-law partner (can be the same sex).
          Monthly payment                                                                                                                                                         family member please
                                                                                                                                                                                  see below)
          Name of Lender
                                                                                                                                                                              E14 If you are letting to a               Yes                                No
    D12 Will this loan/money be                 Yes                          No                                                                                                   family member, will they
        secured by way of a                                                                                                                                                       be residing in at least
        second charge on our                                                                                                                                                      40% of the property
        security?                                                                                                                                                                 (including any garden or
    D13 Are you going to sell                                                                                                                                                     other land used within the
        your present residential                Yes                          No                                                                                                   property?
        property at or before                                                                                                                                                 E15 Will any part of the                  Yes                                No
        completion of any new Future                                                                                                                                              property be used for
        Mortgages loan?                                                                                                                                                           business purposes?**
          If Yes, sale price of property    £                                                                                                                                 E16 Will the property be used             Yes                                No
          If No, please state                                                                                                                                                     by you as your permanent
          intended usage                                                                                                                                                          primary residence?
                                            £                                                                                                                                       If No, please clarify
    D14 Estimated value of
        current property                                                                                                                                                                                         **If you have answered YES to any question from E11 to E15 please provide details in the Additional Information Section J
8                                                                                                                                                                                                                                                                                                                                                                                    9
                                     Section F – Solicitors Details                                                                                                                                                        Section H – Application for Future Guard – Protecting your monthly payment
                                                                                                                                                                                                                           in the event of accident, illness and unemployment
     F1   Would you like to use a          Yes            No
          Future Mortgages Panel
                                      Future Mortgages can arrange a competitive quotation if you do not already have a solicitor                                                                                           All insurances are optional and not a condition or requirement of any mortgage agreement. Your decision regarding the
          solicitor?                                                                                                                                                                                H1   Application for
                                                                                                                                                                                                         Future Guard       purchase of any insurance from Future Mortgages will not affect our credit decision process.
          If no, give details of                                                                                                                                                                                            PLEASE TICK EITHER BOX A OR BOX B
          your own solicitor
          Name of firm                                                                                                                                                                                                      A        I wish to protect my monthly mortgage payments and am applying for the Future Guard mortgage payment
                                                                                                                                                                                                                                     protection plan.
          Name of solicitor acting
                                                                                                                                                                                                                            B        I do not wish to apply for Future Guard and am aware that my home may be repossessed if I do not
          Address                                                                                                                                                                                                                    keep up repayments on my mortgage.
                                                                                                                                                                                                                            If you ticked Box A, please now complete the Personal Details box and then sign and date the Declaration.
                                       Telephone No.                                                                   Fax No.
                                                                                                                                                                                                                           Personal Details
                                       DX no.                                                                          Number of partners
                                      Please Note The solicitors nominated must have a minimum of 2 partners, sole practitioners may not be instructed to act for Future Mortgages                                                                First Applicant                                   Second Applicant (for joint cover applications only)

                                     Section G – Buildings/Contents Insurance                                                                                                                                               Forename(s):                                                      Forename(s):
                                       In all cases, buildings insurance must be maintained under a Household Buildings Policy for a sum not less than that specified
                                       by our valuer. The property may be insured through Future Mortgages’ policy underwritten by certain Underwriters at Lloyd’s                                                          Surname                                                           Surname
                                       of London and other insurers with the sums insured based upon an estimate of current rebuilding costs and increased in line
                                       with the House Rebuilding Cost Index. You should always ensure, however, that the sum is an accurate reflection of the cost of
                                       rebuilding your home.                                                                                                                                                                Important notes
                                       The Future Mortgages’ Combined Buildings and Contents Policy is a simple, cost effective policy designed to cover your                                                               1. Where cover is being requested in joint names the 1st applicant must be the 1st named person on the Mortgage
                                       buildings and contents against a variety of risks available under a ‘no proposal’ arrangement. Full details of the scope of
                                       cover and monthly premium accounts will be forwarded to you with the mortgage offer. Purchasers will also have the                                                                      Agreement and the 2nd applicant must be the 2nd named person on the Mortgage Agreement. The 1st applicant must
                                       benefit of a free period of buildings cover from exchange of contracts (conclusion of missives in Scotland) to completion.                                                              also be the main income earner of the two.
                                       If the property is leasehold and the lease requires cover through an insurance company specified by the landlord, then                                                                  The first applicant will be covered for 100% of the monthly benefit and the 2nd applicant will be covered for 50% of the
                                       cover must be effected in accordance with the lease. In all cases where the property will be insured other than through the                                                             monthly benefit.
                                       Future Mortgages’ Policy Scheme, a copy of the Insurance Policy schedule must be produced and the insurance must
                                       comply with the criteria set out in the mortgage general and special conditions.                                                                                                     2. Each person applying cannot be covered for a monthly amount that is more than 75% of their normal gross monthly
                                                                                                                                                                                                                               earned income (excluding bonuses and overtime). The maximum monthly benefit payable is £1,500.
     G1   If you wish Future                Combined Buildings and Contents                          Buildings Only                      Contents Only                                                                          Where your application is being referred to another lender, that lender’s insurance products will be offered if you
          Mortgages to arrange              (not available on Buy to Let)                            (leasehold only)                                                                                                           tick the box
          insurance, please tick       Security Discounts
          the box to indicate the      As part of Future Mortgages’ Policy, you may be entitled to an additional discount to monthly premium amounts in certain
          cover you require            circumstances. Therefore, please tick the appropriate boxes:                                                                                                                        Declaration (this must be signed by each applicant)
                                            Deadlocked & key operated window locks                                   Neighbourhood watch                             NACOSS alarm
                                                                                                                                                                                                                            I/We declare that I/We have read and understood the leaflet explaining Future Guard and that I/We am/are eligible for
                                            Policyholder aged 50 years or over                                       Voluntary increased policy excess to £100                                                              cover as described. I/We am/are aware that cover is not provided for medical conditions already existing or for
                                                                                                                                                                                                                            unemployment known to me/us to be impending at the time of this application.
                                            Voluntary increased policy excess to £150                                Voluntary increased policy excess to £200

                                      THIS SECTION TO BE COMPLETED BY ALL APPLICANTS, AS THE ANSWERS ARE REQUIRED FOR MORTGAGE UNDERWRITING                                                                                                       First Applicant                                           Second Applicant (if applicable)

                                       Disclosure of Material Facts
                                       As with all contracts of insurance, the insurers require you to disclose any facts which an insurer would regard as likely to
                                       influence the assessment and acceptance of an insurance proposal. Therefore, if you consider that there are any facts which
                                       are, or might be, material you should enclose a note with your application giving full details. Material information would                                                          Signature                                                         Signature
                                       include any special features of the property’s insurance, construction or occupancy, or details about any member of your
                                       household which makes losses more likely to occur, or more serious if they did. Failure to disclose all material information                                                        Date                                                              Date
                                       may result in your being quoted the wrong terms, a claim being rejected or reduced or the policy being invalid. You should
                                       keep a record (including copies of letters) of all information supplied for the purpose of entering into the insurance contract.
                                       Please answer the following questions to the best of your knowledge and belief:                                                                                                     Section I – Important Future Communication Information
     G2   Have you or any persons      a. Been convicted or charged with any offence other than a driving offence?                                                   Yes             No                                     As a valued customer, we may, from time to time, communicate to you preferential product and service special offers,
          normally resident with
                                       b. Had any Home or Personal Insurance declined, cancelled or had special terms imposed?                                       Yes             No                                     which we feel will be of benefit to you. To ensure you receive this information please tick the box/boxes below of accepted
                                                                                                                                                                                                                            communication channels you would like us to use.
                                       c. Sustained any loss, damage or liability during the past 5 years whether insured or not?                                    Yes             No                                         Post      Telephone      Fax*     SMS Text Messaging*        Email*
                                                                                                                                                                                                                            *Please note these services are currently unavailable. If you wish to receive preferential product and service information
     G3   Will the property be               Yes       No                                                                                                                                                                   prior to this service being made available, please also tick the box against the post or telephone options. Once these
          left unoccupied for any      If you have answered ‘YES’ to questions G2 & G3 or you are in any doubt whether facts are material, please provide full                                                              services are available, we will begin to communicate through these channels.
          reason for more than 30      details in the Additional Information section. The answers you have given to these questions will usually provide sufficient                                                         By signing this I/We expressly consent to allow Future Mortgages Ltd, CitiFinancial Europe plc, Citibank International plc,
          consecutive days?            information to enable us to consider the proposal. However, because no list of questions can be exhaustive, please consider                                                          CitiSolutions Financial (UK) Limited, CitiInsurance Life Assurance Company Limited and CitiInsurance General Insurance
                                       carefully whether there is any other material information known to you which could influence the acceptance and                                                                      Company Limited to contact us regarding information about their products by the method(s) indicated.
                                       assessment of the risk. The cover will be issued on the basis of the information provided by you on your behalf. Please
                                       inform the insurer immediately of any changes that affect what you have disclosed above, e.g. changes in the use of the
                                       property, or if an extension is added to the property address, etc.                                                                                                                                        First Applicant                                           Second Applicant (if applicable)
                                       Additional Notes
                                       A summary of cover, or a full statement of cover with full Policy Wording, is available on request. Insurers and agents share
                                       information with each other to prevent fraudulent claims and to assess whether to offer insurance, including the terms, via
                                       the Claims and Underwriting Exchange Register, operated by Insurance Database Services Ltd. A list of participants is                                                               Signature                                                         Signature
                                       available on request. In dealing with your application this register may be searched. In the event of a claim, the information
                                       you supply on this form and the claim form, together with other information relating to the claim, will be put on the register                                                      Date                                                              Date
                                       and made available to participants.
                                       Contract Law
                                       The parties to this contract are free to choose the law applicable to it. Unless specifically agreed to the contrary with
                                       insurers, this insurance shall be subject to English Law.
                                       Where your application is being referred to another lender, that lender’s insurance products will be offered if you
                                       tick the box

                                     The purchase of any insurances offered by Future Mortgages is optional and not a condition or requirement of any loan agreement. Your decision regarding the
10                                   purchase of insurances will not affect our credit decision process.
     Section J – Additional Information   Section K – Declarations
                                          I/We agree and declare that:                                                         9.    I/We* understand that Future Mortgages Ltd will use a credit scoring or
            Question No.                  1.  The details contained in this application are true and accurate and I/We*              other automated decision making system when assessing My/Our*
                                              shall notify Future Mortgages Ltd if, before any loan is made, the                     application.
                                              information is found to be incorrect or changes. I/We* understand that if
                                              this application is successful the details in it form part of the terms of the   10. Future Mortgages Ltd may process all the information which I/We* or
                                              mortgage.                                                                            My/Our/Your* agents provide to Future Mortgages Ltd for any purpose
                                                                                                                                   connected with the proposed entry by Me/Us* into a mortgage, and (if
                                          2.   Future Mortgages Ltd is authorised to instruct qualified valuers to carry out       applicable) a related insurance policy, with Future Mortgages Ltd, and with
                                               a valuation of the property upon receipt of this application at its cost. The       the administration of any such mortgage and (if applicable) related
                                               valuation report is to be obtained solely for the benefit of Future Mortgages       insurance policy that I/We* enter into. Such processing shall include
                                               Ltd, to enable it to assess the amount of the mortgage loan (if any) it is          without limitation entering the information onto computer systems, making
                                               prepared to make on the security of the property referred to in the                 enquiries, taking up references, credit assessment, dealing with any
                                               application. I/We* accept that the valuation report confers no rights on            intermediary involved in arranging My/Our* mortgage, carrying out any
                                               Me/Us* whether against Future Mortgages Ltd or other persons on the                 internal administration, any ancillary purposes and any other purposes
                                               basis of negligence or whatsoever in respect of the value or state or               which Future Mortgages Ltd has notified the Office of the Information
                                               condition of the property.                                                          Commissioner, that it may make of such information. In so doing, Future
                                                                                                                                   Mortgages Ltd shall be entitled to disclose the information to any of its
                                               I/We* understand that Future Mortgages Ltd is not the agent of the valuers          employees, third party contractors who carry out any functions on Future
                                               and that neither Future Mortgages Ltd nor the valuers will represent or give        Mortgages Ltd’s behalf, solicitors, valuers, other professionals, credit
                                               any assurance to Me/Us* that the statements, conclusions and opinions               reference agencies, referees and other companies in the same group as
                                               expressed or implied in the report and mortgage valuation are accurate or           Future Mortgages Ltd, or any proposed assignee or transferee of any
                                               valid and that the valuation report will be supplied without any acceptance         mortgage offer or mortgage.
                                               of responsibility on their part to Me/Us*.
                                                                                                                               11.   To prevent and detect fraud, or to assist in verifying your identity, we may
                                               I/We* accept that I/We* must for My/Our* protection, obtain independent               make searches of Group records and will check your details with fraud
                                               advice from a surveyor or other professional person as to the condition and           prevention agencies who will supply us with information. We may also pass
                                               value of the property.                                                                information to financial and other organisations involved in fraud
                                                                                                                                     prevention to protect ourselves and our customers from theft and fraud. If
                                          3.   Future Mortgages Ltd is entitled to make such arrangements as it thinks fit           you give us false or inaccurate information and we suspect fraud, we will
                                               with third parties to protect itself against any failure by Me/Us* to pay the         record this. We, members of the Group and other organisations may use
                                               mortgage loan, and that any such arrangements will be for the benefit of              these records to:
                                               Future Mortgages Ltd and not Me/Us*. I/We* further acknowledge that                   • Help make decisions about credit and credit related services, for you and
                                               Future Mortgages Ltd may pass such third parties any information                        members of your household;
                                               contained in this application together with any relevant supporting                   • Help make decisions on motor, household, credit, life and other insurance
                                               documentation.                                                                          proposals and insurance claims, for you and members of your household;
                                                                                                                                     • Trace debtors, recover debt, prevent fraud and to manage your accounts
                                          4.   I/We* consent to Future Mortgages Ltd and its successors in title and                   or insurance policies;
                                               assigns whether at law or in equity and whether as a whole or in part and             • Check your identity to prevent money laundering, unless you furnish us
                                               whether by absolute assignment or by way of security only at any time after             with other satisfactory proof of identity
                                               a mortgage offer or mortgage have been made:
                                               i) Transferring, assigning or otherwise disposing of the benefits of such             If you want to receive details of those fraud prevention agencies from
                                               mortgage offer, or mortgage and other related security:                               whom we obtain and with whom we record information about you, please
                                               ii) entering into any contractual arrangements relating to the funding of             contact The Data Protection Officer, Future Mortgages, 6 Admiral Way,
                                               such mortgage offer, or mortgage with any person;                                     Doxford International Business Park, Sunderland SR3 3XW. You have a legal
                                               iii) Supplying any information contained in this application and any                  right to these details.
                                               supporting documentation which may hereafter be provided or any other
                                               information relating to the property, any mortgage offer, the mortgage, the     12. I/We* accept that in considering My/Our* application for credit and any
                                               related security for the mortgage or the history and conduct of My/Our*             relevant insurance Future Mortgages Ltd will search My/Our* record at
                                               account to any interested or potentially interested person, who may rely            credit reference agencies who will supply Future Mortgages Ltd with credit
                                               upon the truth and accuracy of the information contained in this                    information, as well as information from the electoral register. The credit
                                               application.                                                                        reference agencies will add to My/Our* records details of the search
                                                                                                                                   whether or not My/Our* application proceeds. Credit searches, other
                                               I/We* confirm that references in this application to Future Mortgages Ltd           information which is provided to Future Mortgages Ltd and/or the credit
                                               include its successors in title and assigns whether at law or in equity and         reference agencies about Me/Us* and those whom I/We* are linked
                                               whether as to whole or to part.                                                     financially may be used by Future Mortgages Ltd and other companies if
                                                                                                                                   credit decisions are made about Me/Us* or other members of My/Our*
                                          5.   Future Mortgages Ltd may forward statements of account, or other such               household. Future Mortgages Ltd search will be seen by other organisations
                                               communication to one or all of the borrowers and not necessarily to each            which make credit searches.
                                               borrower individually.
                                                                                                                                     For these purposes Future Mortgages Ltd, or agencies, may make further
                                          6.   If interest payments (or other payments) are collected from an account                searches although these will be added to My/Our* record, they will not be
                                               which is not in the names of all borrowers, the payment will be made for and          shared with others.
                                               on behalf of all joint borrowers named on this application form.
                                                                                                                               13. Information held about Me/Us* by the credit reference agencies may
                                          7.   My/Our* Solicitor may disclose to Future Mortgages Ltd any information              already be linked to records relating to one or more of My/Our* partners.
                                               relevant to their decision to lend and I/We* waive any right to claim               For the purposes of this application I/We* may be treated as financially
                                               Solicitor/Client confidentiality or legal privilege in respect of such              linked and My/Our* application will be assessed with reference to any
                                               information.                                                                        “associated” records. If I am a joint applicant or if I have told Future
                                                                                                                                   Mortgages Ltd of some other financial association with another person, I
                                          8.   Future Mortgages Ltd may contact My/Our* employers (past and present),              must be sure that I am entitled to:
                                               bankers, other lenders (past and present), accountants, landlords or other          – disclose information about my joint applicant and anyone referred to by me;
                                               person necessary to verify the information given by Me/Us* in this                  – authorise Future Mortgages Ltd to search, link or record information at
                                               application.                                                                        credit reference agencies about me and anyone referred to by me. An
                                                                                                                                   “association” between joint applicants and between Me/Us* and anyone
                                                                                                                                   I/We* tell Future Mortgages Ltd is My/Our* financial partner will be created
                                                                                                                                   at the credit reference agencies. This will link My/Our* financial records,

12                                                                                                                                                                                                                  13
     Section K – Declarations continued                                                     Section K – Declarations continued

           each of which will be taken into account in all future applications by either          Important use of your information
           myself of both of us. This will continue until one of us successfully files a      A. You have the right to know how we will use your personal information.         F. We or other companies of our group and other reputable organisations
           disassociation at the credit reference agencies.
                                                                                                  It is important that you should read this notice, to ensure you are fully          chosen by us will use, analyse and assess your information to maintain
     14. Where I/We* borrow from Future Mortgages Ltd, they may give details of                   aware of how your personal information is being used and your rights in            and develop our and their relationships with you. The types of activity
         My/Our* account and how I/We* manage it to credit reference agencies.                    that regard.                                                                       that this will include are:
         If I/We* borrow and do not repay in full and on time, Future Mortgages Ltd               i) YOU   HAVE A RIGHT TO RECEIVE A COPY OF THE INFORMATION WE HOLD                 i) considering any further applications made by you and helping us make
         may tell credit reference agencies who will record the outstanding debt.                  ABOUT YOU IF YOU APPLY TO US IN WRITING: DATA PROTECTION OFFICER,                 credit-related decisions about you and your account with us;
                                                                                                   FUTURE MORTGAGES, 6 ADMIRAL WAY, DOXFORD INTERNATIONAL BUSINESS
                                                                                                                                                                                     ii) operating and administering the products and services we and/or
     15. Future Mortgages Ltd will also add to My/Our* record with the credit                      PARK, SUNDERLAND, SR3 3XW. A FEE WILL BE PAYABLE
         reference agencies details of My/Our* agreement with Future Mortgages                                                                                                       they supply;
                                                                                                  ii) If you do not wish to receive further information please tick where
         Ltd the payments I/We* make under it and any default or failure to keep to                                                                                                  iii) servicing your relationships with other companies of our group and
         its terms and any change of address where a payment is overdue. It is                    applicable, in the relevant section of the application form, Section I.
                                                                                                                                                                                     other organisation;
         important that I/We* give Future Mortgages Ltd accurate information.                 B. We value your privacy and have a policy (“our Privacy Promise”) to hold
                                                                                                                                                                                     iv) helping us and them to identify products and services which may be
                                                                                                  in confidence, information about you and your account. However, in
     16. Future Mortgages Ltd funds borrowers using a number of different companies                                                                                                  of interest to you (unless you have asked us not to); and
                                                                                                  certain circumstances, we may disclose or transfer this information, for
         including companies outside of the Future Mortgages group. Which particular                                                                                                 v) helping us and them to understand and develop our and their
         Future Mortgages company makes the advance, will depend on a decision                    example:
                                                                                                                                                                                     businesses, including new and innovative products and services.
         made by Future Mortgages Ltd at the time the mortgage offer is made or, in               i) if permitted by these Terms and Conditions or your original application
         the case of a company outside its group, it will depend on the particular                ii) if required to do so by any court order or similar process
         product you have chosen. This application form and the declarations contained                                                                                         G. For operational reasons in order to carry out the activities listed in (F)
                                                                                                  iii) If required or permitted to do so by law or by the rules of any
         in it will therefore be relied upon by Future Mortgages Ltd, its subsidiary                                                                                                 above we may:
                                                                                                  regulatory body of which we are a member or whose rules or provisions
         companies or other companies within the same group as Future Mortgages                                                                                                      i) link your information between your account and other products and
         Ltd and companies outside its group and all prospective successors in title              apply to such as, but not limited to, the Financial Services Authority and
                                                                                                                                                                                     services you maintain with us; and
         and assigns (whether legal or equitable and whether by absolute assignment               Office of Fair Trading.
                                                                                                                                                                                     ii) link or use information we receive from third parties about you and
         or by way of security only). Any reference within this Application Form and              iv) to the USA and other countries (where necessary) outside the
         Declarations to Future Mortgages Ltd shall refer to each such company and,                                                                                                  the conduct of your account, and also your information with information
                                                                                                  European Union to administer and service your application and or your
         if applicable any insurance company providing Future Mortgages Ltd or the                                                                                                   about others with whom you have a financial association. Unless you
         applicant(s) with any insurance relating to the mortgage loan, the                       account. You understand that data protection laws are not as
                                                                                                                                                                                     write to tell us not to, we may use the links or information received from
         applicants(s) or the property so that, where relevant, references to the                 comprehensive in the USA and other countries as in the European
                                                                                                                                                                                     third parties for marketing purposes.
         Future Mortgages Ltd also include such insurance companies.                              Union. Please telephone 08457 388873 if you wish to receive details of
                                                                                                  those countries where your data may be transferred to be processed.
     17.   I/We* understand that my loan will be subject to various fees which may be                                                                                          H. As our means of delivering products and services evolve, the way in
           added to the agreed loan (the Gross Advance) and deducted at completion
                                                                                                  However, where such a disclosure takes place we will ensure a contract is
                                                                                                                                                                                     which we look at, record and use your information, may develop. In most
           prior to the balance of monies (the Net Advance) being paid to my solicitor.           in place to ensure the level of protection for your data is maintained.
                                                                                                                                                                                     cases these developments will result from improvements in technology.
           Whilst these fees may vary from time to time. I/We* acknowledge that                   v) if we are under a public duty to disclose;
           details of fees that apply to My/Our* loan can be or have been confirmed to                                                                                               Where we believe the developments may not be obvious to you, we may
                                                                                                  vi) if it is in our own interests.
           Me/Us* prior to submission and by submitting this application to Future                                                                                                   give you notice of them. However, once we have notified you of any
                                                                                                  vii) at your request or with your consent.
           Mortgages Ltd I/We accept charging of these fees.                                                                                                                         developments and your account is being maintained for at least 45 days,
                                                                                                                                                                                     we will accept that you will be consenting to that development.
     18. It is important to read and understand this declaration and the sheet entitled       C. We may disclose or transfer details of your relationship with us to other
         Use of Your Information. By signing this application I/We* agree that Future             organisations within our group for their confidential and internal use.
         Mortgages Ltd can use My/Our* information this way.                                                                                                                   I.    Any information that we may receive from third parties including but not
                                                                                                  We may also disclose such details to organisations within our group or
                                                                                                                                                                                     limited to details of your transactions, including the name of the recipient
     19. I/We* confirm that we have received a Key Facts Illustration in respect of the           other third parties where it is reasonably necessary to do so for
                                                                                                                                                                                     of the transaction and the methods used for that transaction made in
         regulated mortgage contract I/We* have applied for (for RMC’s only).                     processing your details with us, or them, or to enable them to provide
                                                                                                                                                                                     relation to your account, may be kept by and used by us for analysis in
                                                                                                  services to you.
           *Please delete as appropriate                                                                                                                                             order to provide you with better services, or to mail or call you with any
                                                                                                                                                                                     products and services that may be of interest to you. You have a right at
                                                                                              D. If your account is closed for any reason, we will hold your information
                                                                                                                                                                                     any time to stop us from contacting you, as set out in (A) above.
                                                                                                  about you and your account for no longer than is absolutely necessary.

                                                                                                                                                                               J. We may undertake further searches at the Credit Reference Agencies to
                                                                                              E. We may transfer your personal data to our parent company, Citigroup
                                                                                                                                                                                     manage your account with us, to make a decision about your credit limit
                                                                                                  Inc. (or any other parent as a result of merger or amalgamation or
                                                                                                                                                                                     and if we wish to make other products, services or benefits available to you.
                                                                                                  corporate restructure) and any other Citigroup organisation in Europe
                                                                                                  or the USA, for processing.

                                                                                                                             First Applicant                                                                       Second Applicant

                                                                                           Signature                                                                                Signature

                                                                                           Date                                                                                     Date

                                                                                                       YOUR HOME MAY BE REPOSSESSED IF YOU DO NOT KEEP UP REPAYMENTS ON YOUR MORTGAGE

14                                                                                                                                                                                                                                                                   15
                                            Section Li – Payment of Fees by Credit/Debit Card                                                                         Section M – Instructions to your Bank/Building Society to pay Direct Debits
                                            As payment is required with the application, this method may help to speed the process
     If you would like to pay the fee
     shown below by credit/debit card,           Application Fee               Booking Fee (if applicable)
     please tick the box and complete
     the following details

     Method of Payment                           MasterCard                    Visa              Delta             Switch               Amex          Cheque
     I authorise you to debit my             £
     account with the amount of                                                                                                                                   Please fill in the whole form, including official use box, using       Instruction to your Bank or Building Society
     My card number is
                                                                                                                                                                  a ball point pen and send it to:                                       to pay by Direct Debit
     Security code
     (The last 3 digits on the reverse of                                                                                                                                                                                                Originator’s Identification Number
     your card on the signature strip)                                                                                                                                The Manager
     Issue number                                                                                                                                                     Future Mortgages Ltd                                                4 1 6 0 7 6
     (Switch cards only)
                                                                                                                                                                      6 Admiral Way
     Expiry date
                                                                                                                                                                      Doxford International Business Park                                   FOR FUTURE MORTGAGES LTD OFFICIAL USE ONLY
                                                                                                                                                                      Sunderland                                                           This is not part of the instruction to your Bank or Building Society
     (as it appears on the card)                                                                                                                                      SR3 3XW                                                              Please choose which day of the month you would prefer
     Address                                                                                                                                                                                                                               payment to be collected
     (as it appears in the                                                                                                                                        Name(s) of Account Holder(s)
     card issuer’s records)                                                                                                                                                                                                                1st        14th


     Signature of cardholder
                                                                                                                                                                  Bank/Building Society account number


                                                                                                                                                                  Branch Sort Code
                                            Section Lii – Additional Fees
                                                                                                                                                                                                                                         Instruction to your Bank or Building Society
                                            Please indicate how you would like to pay the following fees.                                                                                                                                Please pay Future Mortgages Ltd Direct Debits from the
                                                                                                                                                                  Name and full postal address of your Bank or Building Society
                                            Add to Loan                   Pay prior to Completion                                                                                                                                        account detailed in this instruction subject to the safeguards

     Completion Fee                                                                                                                                                   To: The Manager                     Bank/Building Society          assured by the Direct Debit Guarantee. I understand that this
                                                                                                                                                                                                                                         instruction may remain with Future Mortgages Ltd and, if so,
                                                                                                                                                                      Address                                                            details will be passed electronically to my Bank/Building Society.
     Freedom of Agency

     Local Search Indemnity                                                                                                                                                                                Postcode                        Signature(s)

                                            If you would like to pay the fees please tick the box and complete the following details.                             Future Mortgages Ltd reference number
                                                                                                                                                                  (to be completed by Future Mortgages Ltd)
     Method of Payment                           MasterCard                    Visa              Delta             Switch               Amex          Cheque
     I authorise you to debit my
     account with the amount of

     My card number is
     Security code
     (The last 3 digits on the reverse of                                                                                                                         ✁                   Bank and Building Societies may not accept Direct Debit instructions for some types of account
     your card on the signature strip)
                                                                                                                                                                                                      This guarantee should be detached and retained by the Payer
     Issue number
     (Switch cards only)

     Expiry date
                                                                                                                                                                                                                The Direct Debit Guarantee
     (as it appears on the card)

     Address                                                                                                                                                              •   This guarantee is offered by all Banks and Building Societies that take part in the Direct Debit scheme.
     (as it appears in the                                                                                                                                                    The efficiency and security of the scheme is monitored and protected by your own Bank or Building Society.
     card issuer’s records)

                                                                                                                                               Postcode                   •   If the amounts to be paid or the payment dates change Future Mortgages Ltd will notify
                                                                                                                                                                              you 10 working days in advance of your account being debited or as otherwise agreed.

                                                                                                                                                                          •   If an error is made by Future Mortgages Ltd or your Bank or Building Society, you are guaranteed a full and
     Signature of cardholder                                                                                                                                                  immediate refund from your branch of the amount paid.
     Date                                                                                                                                                                 •   You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also forward a copy
                                            Cheque payments are to be received at least 10 days before completion. Failure to pay on time will result in delay.               of your letter to us.
                                            If paying by credit/debit card, these fees will be deducted at completion stage.

16                                                                                                                                                                                                                                                                                                                17
Certificate of Authorisation
Please complete this form and fax to: Future Mortgages 0870 4106700

Mortgage Application Number

I authorise Future Mortgages Ltd to contact my/our employers (past and present) bankers, other lenders (past and present),
accountants, landlords or any other person necessary to verify the information given by me/us in this Application.

              First Applicant                                                         Second Applicant

Name                                                                   Name

Signature                                                              Signature

Date                                                                   Date


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