The items marked * are required.

This information is being collected as background information
for use when arranging an appointment with you.
By completing this form you are giving your permission for us
to contact you by telephone.

 

   
Applicant 1
Applicant 2
       
Title:
*
Forename or initials:
*
Surname:
*
Date of birth (dd/mm/yyyy):
*
Address:



*
Postcode:
*
Length of time at above address:
* years * months years months
Contact telephone:
*
E-Mail:
*
Fax:
 
Marital status:
*
On electoral register?
*
Residential status:
*
YOUR CIRCUMSTANCES  
Employment status:*
Gross annual earnings:*
£ £
Other income per annum:
£ £
Loans/credit cards outstanding
(excluding current mortgage if to be cleared):
£ £
Monthly repayments on the above: £ £
REASON FOR ENQUIRY*
Equity Release' includes home reversion plans and lifetime mortgages. To understand the features and risks, ask for a personalised illustration.
PROPERTY TO BE BOUGHT/REMORTGAGED  
Purchase price/approximate value:*
£
MORTGAGE REQUIRED    
Amount and type:*
£ *
Term and rate preferred*
years *
Existing mortgage lender, if any
OTHER INFORMATION OR COMMENTS:
e.g. arrears, ccjs guarantors etc

I/we expressly consent to be being contacted without prior notice or arrangement by using the contact details I/we have provided on the form and further consent that such contact may be in relation to (a) my/our mortgage arrangements and/or (b) other products and services.



Your property may be repossessed if you do not keep up repayments on your mortgage


MedDen Financial Services LLP

MedDen House
3 Hanover Avenue
Leeds
West Yorkshire
UK
LS3 1BG
Location MapDirections

tel: 0113 2470088
fax: 0113 2987367
enquiries@meddenifa.com

Registration Address: As Above
Registered in UK, No:OC330966


MedDen Financial Services LLP is Authorised and Regulated by the Financial Conduct Authority.

MedDen Financial Services LLP is entered on the Financial Services Register (www.fsa.gov.uk/register/) under reference 473375