Salutation: Please Select Mr Mrs Miss Ms Dr. Sir Other

Firstname(s):

Surname:

Are you purchasing as an individual or limited company?: Please Select Individual Limited

Name of Company:

Contact Telephone:

Email Address:

Address 1:

Address 2:

Town:

County:

Postcode:

Property Information

Property Type: Please Select Commercial Residential Purpose Built Flat Converted Flat Maisonette Detached House Semi-Detached House Terraced House Bungalow Office Industrial Leisure Retail Mixed

Tenure: Please Select Freehold Leasehold

Type of business: - Please Choose - Agricultural Automotive Banking/Finance Charity Conference/Exhibition Organiser Construction Consumer Durables Corporate Hospitality/Events Cosmetics/Toiletries Creative/Design Direct Marketing Direct Response Handling Electrical Goods FMCG Food/Drink/Tobacco Incentive Travel Information Technology Insurance Leisure Manufacturing Packaging Paper/Print/Publishing Petrochemical Pharmaceutical Recruitment/Training/HR Retail/Wholesale Sales Promotion Agency Telecommunications Textiles Transport Travel White Goods Other (please specify)

Property Value / Purchase Price (£):

How much do you wish to borrow? (£):

Mortgage Type: Please Select Development Investment Purchase Remortgage

Term: Please Select 5 10 15 20 25

Turnover (£):

Net Profit (£):

Please add any other relevant information in the box below