NB: A form is required from all Directors with a shareholding of 20% or more, even where they do not give mortgage advice.
Yes
No*
please provide an explanation in the Other Information box.
Have you held CeMAP for 12 months or more?
Have you been advising on mortgages for 12 months or more?
Do you have a Consumer Credit Licence?
Are you registered for Data Protection?
Is your income in excess of £20,000 pa?
Can you provide 3 years accounts and/or a projection and business plan?
Do your assets exceed your liabilities - including any property you own?
Can we obtain a FULL 10 year history of your employment?

 

 
Yes*
please provide an explanation in the Other Information box.
No
Have you ever:
Been subject to any criminal proceedings?
Had a CCJ or been made bankrupt, or are you aware of any intention to bring any such proceedings against you?
Been disqualified from being a Director?
Been subject to any investigation into allegations of malpractice, misconduct, requested to resign, had any licence revoked, been censured or disciplined by any professional or regulatory body – or anything similar – in connection with your business affairs?
If you have any reason to believe that we need to be aware of anything please provide details in the box below*. If in doubt, please provide details and we can assess the effect, if any, on your application. If you do not disclose anything that we later discover, your application may be declined.    

Other Information:*
Applicants Name:
Company Name:
Private Address:
 
Telephone:
Fax:
Email:
FSA No (if any):
I authorise Mortgage Next to make any enquiries, including from a credit reference agency, as it shall deem necessary in considering this application. I understand that a record of any search will appear on my credit agency file.
(Please Tick)