Applicant Name
*
First Name
Last Name
Applicant Title
*
-
Mr
Mrs
Miss
Ms
Applicant Gender
*
-
Male
Female
I'd prefer not to say
Applicant Phone Number
*
Applicant Email Address
*
Applicant Email Address (Confirm)
Applicant Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
When did you move in?
*
Applicant Correspondence Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Please tell us why you would like us to write to this address
Company Name
Street Address
City/Town
Postcode
Phone No.
Your Current Salary (£)
Work Email Address
Contact Name
Are you, or anyone residing with you a:
If 'Other', please specify
Property Size Required
*
-
Studio
1 Bedroom
2 Bedroom
3 Bedroom
What are you applying for?
*
-
Rent
Shared Ownership
Social Home Buy
Address 1
Address 1 - Move in Date
Address 1 - Move Out Date
Address 1 - Landlord
Address 1 - Position
Reason For Leaving Address 1
Address 2
Address 2 - Move in Date
Address 2 - Move Out Date
Address 2 - Landlord
Address 2 - Position
Reason for Leaving Address 2
Partner Name
First Name
Last Name
Partner Title
-
Mr
Mrs
Miss
Ms
Partner Gender
-
Male
Female
I'd prefer not to say
Partner Date of Birth
What is your Partners relationship to you?
Will your partner be a joint tenant?
Partners Previous Address
Date From
Date To
Type of Landlord
Type of Position
Reason for Leaving
Person 1
First Name
Last Name
Person 1 - Title
-
Mr
Mrs
Miss
Ms
Person 1 - Gender
-
Male
Female
I'd prefer not to say
Person 1 - DoB
What is Person 1's Relationship to You?
Will Person 1 be a Joint Tenant?
Person 1's - Current Address
If this person is not living with you now but will be moving with you then please enter their current address below
Person 2
(if applicable)
First Name
Last Name
Person 2 - Title
-
Mr
Mrs
Miss
Ms
Person 2 - Gender
-
Male
Female
I'd prefer not to say
Person 2 -DoB
What is Person 2's Relationship to You?
Will Person 2 be a Joint Tenant?
Person 2's Current Address
If this person is not living with you now but will be moving with you then please enter their current address below
Person 3
(if applicable)
First Name
Last Name
Person 3 - Title
-
Mr
Mrs
Miss
Ms
Person 3 - Gender
-
Male
Female
I'd prefer not to say
Person 3 - DoB
What is Person 3's Relationship to You?
Will Person 3 be a Joint Tenant?
Person 3's Current Address
If this person is not living with you now but will be moving with you then please enter their current address below
Please include the following for each person this applies to.
Persons full name, their disability or health condition & how it affects their living situation.
Is the Property
*
Select One
Privately Owned
Housing Association
Council
Other
What Type of Property Do You Live In
*
Select One
Flat
House
Maisonette
Hostel
Other
Number of Beds
*
Select One
1
2
3
4
How Would You Describe Yourself?
*
Select One
White - British
White - Irish
Any other White background
Mixed - White and Black Caribbean
Mixed - White and Black African
Mixed - White and Asian
Any other Mixed/Multiple ethnic background
Asian - Indian
Asian - Pakistani
Asian - Bangladeshi
Asian - Chinese
Any other Asian background
Black - African
Black - Caribbean
Any other Black background
Other
If any other background, please describe
1. Do you have access to at least £1,500 to cover the cost of moving and legal fees? Stamp duty (if applicable) is not included in this amount
*
2. What is your total annual income before deductions? (Excluse overtime and bonuses but include pensions)
*
3. How much overtime, bonuses and commission do you normally earn (in total) in a year?
*
4. What are your savings?
*
5. Have you been in rent arrears in the last 12 months?
*
6. Do you have any outstanding loans?
*
7. Do you have any outstanding credit cards?
*
8. Do you have regular monthly financial commitments? (For example, child maintenance)
*
9. Are you in receipt of any benefits
*
10. Have you ever had a home repossessed?
*
11. Have you ever been declared bankrupt?
*
12. If yes, has this been discharged?
13. Have you ever had any county court judgements? (CCJs)
*
14. If yes, have they been satisfied?
15. Have you ever defaulted on a loan?
*
16. Have you ever been refused a mortgage?
*
17. Are you currently in an IVA (Individual Voluntary Arrangement)?
*
Do you have access to at least £1,500 to cover the cost of moving and legal fees? Stamp duty (if applicable) is not included in this amount
What is your total annual income before deductions? (Excluse overtime and bonuses but include pensions)
How much overtime, bonuses and commission do you normally earn (in total) in a year?
What are your savings?
Have you been in rent arrears in the last 12 months?
Do you have any outstanding loans?
Do you have any outstanding credit cards?
Do you have regular monthly financial commitments? (For example, child maintenance)
Are you in receipt of any benefits
Have you ever had a home repossessed?
Have you ever been declared bankrupt?
If yes, has this been discharged?
Have you ever had any county court judgements? (CCJs)
If yes, have they been satisfied?
Have you ever defaulted on a loan?
Have you ever been refused a mortgage?
Are you currently in an IVA (Individual Voluntary Arrangement)?
Please use the space below to provide any extra information that may help your application
I confirm that the information entered in this form is accurate to the best of my knowledge
*
I confirm that I've read and agree to the Disclaimer and Privacy Policy (listed below)
*
