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  ASSET & LIABILITY STATEMENT
 
Name (1) Name (2)
Date of Birth Date of Birth
Dependants & age Dependants & age
Home Address Home Address
Telephone Telephone
Email Email
Occupation Occupation
Annual Salary Annual Salary
Other income- give details Other income- give details

Give details (below) of existing property portfolio including main residence or attach a separate schedule.
Please state if owned other than in your own name.

Address

Value

Loan outstanding

Lender

Purchase price & date

Rental income
  Assets   Liabilities
Savings / Credit balances Personal overdraft
Vehicles  Personal Loans
Investment/ shares Hire Purchase

Life Policies
A(Life cover
B)Surrender value

 Credit Card
Other assets Other Financial Liabilities
Liabilities of Adverse Credit
 

Declaration:   I / We understand that you are relying on this information provided in deciding to grant facilities to the
                                undersigned. I / We certify that the information provided is true and correct.
Date:
 
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Your home may be repossessed if you do not keep up repayments on your mortgage or any other debt secured on it. There will be a fee for mortgage advice. The precise amount will depend upon your circumstances but we estimate that it will be 1.5% of the loan value.
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