Application Form Windmill Place, Bushey Equity Share Homes

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1 Applicatin Frm Windmill Place, Bushey Equity Share Hmes Please fill in this frm in BLOCK CAPITALS and black ink, then return it t; bpha Ltd, Bedfrd heights, Mantn Lane, Bedfrd, MK41 7BJ We are unable t cnsider yur applicatin unless all the sectins are fully cmpleted with all supprting dcuments attached with the cmpleted frm. Sectin 1 - PERSONAL DETAILS Title (Mr, Mrs, Miss,Ms, Other) Last Name First Name Middle Name/s (if applicable) Date f Birth Address Pstcde Hw Lng Have Yu Lived There? Hme Telephne Number: Mbile Telephne Number Address Are yu Expecting a Baby? Hw wuld yu describe the cmpsitin f yur husehld? Yes N Yes N Single Cuple Cuple with Children Single with Children Sharing Other (Please state) Sectin 2 - EMPLOYMENT DETAILS Are yu Emplyed Jb Title Emplyers Name Emplyers Address Yes N Yes N Emplyers Telephne Number Place f Wrk Natinal Insurance Number

2 Sectin 3 - HOUSEHOLD INFORMATION Apart frm Applicants 1 and 2, will anyne else be living in the prperty yu purchase? Yes Hw Many Peple? Cmplete Sectin 3A N Sectin 3A - RESIDENT INFORMATION Full Name Gender Date f Birth Residents Relatinship t Applicants ne and / r Tw Emplyment Status Annual Salary (if applicable) RESIDENT ONE RESIDENT TWO Full Name Gender Date f Birth Residents Relatinship t Applicants ne and / r Tw Emplyment Status Annual Salary (if applicable) RESIDENT THREE RESIDENT FOUR Sectin 4 Cnnectin t the Brugh D yu have a cnnectin t the Brugh f Hertsmere If yes, please state what the cnnectin is: RESIDENT ONE Yes N I live in Hertsmere: RESIDENT TWO Yes N I live in Hertsmere: I wrk in Hertsmere: I wrk in Hertsmere: If yu have family in the brugh, Please state their relatinship t yu I have immediate family in the brugh Parent Sibling Other: I have immediate family in the brugh Parent Sibling Other:

3 Sectin 5 Current Husing Situatin Are Yu? (Please tick all that apply) A First Time Buyer A Lcal Authrity Tenant A Husing Assciatin Tenant A Shared Owner A Current Hme Owner A Previus Hme Owner Renting Privately On A Husing Assciatin / Lcal; Authrity Waiting List Living With family r Friends Renting Frm yur Emplyer Please prvide name & address f yur landlrd if a private tenant, renting frm yur emplyer r renting frm a husing Assciatin r Lcal Authrity.

4 Sectin 6 Financial Infrmatin What is yur Annual Salary D yu receive any bnuses, cmmissin r vertime? If yes please prvide further infrmatin: What level f savings d yu have? What depsit will yu place n the purchase? Please cmplete belw fr any lans, credit cards r any ther lan r finance agreements yu may have. Amunt Mnthly Reasn fr End Date Applicant Outstanding Payment Lan Lan / Credit Card 1 One Tw Lan / Credit Card 2 One Tw Lan / Credit Card 3 One Tw Lan / Credit Card 4 One Tw Sectin 7 - Are yu, r is anyne n yur applicatin a Lcal Authrity Cuncillr r Cuncil emplyee. Or are yu r anyne n yur applicatin related t r have a clse cnnectin t a Lcal Authrity Cuncillr r a Cuncil emplyee. Yes N Yes N If yes, please cnfirm their: Name: Psitin: Name: Psitin:

5 Supprting Dcumentatin Yu Will Need PROOF OF INCOME - Please frward prf f incme fr all applicants. If emplyed, please frward cpies f yur three mnths mst recent wage slips. If self emplyed, please frward cpies f yur tw years mst recent certified accunts. PROOF OF CONNECTION: Please frward a cpy f ne f the fllwing: If yu live in the brugh, please frward a cpy f yur mst recent cuncil tax statement. If yu live with Parents in the brugh, please frward a cpy f their mst recent cuncil tax statement alng with a cpy f yur birth certificate shwing yur name and their name. If yu have immediate family in the area please frward a cpy f their mst recent cuncil tax statement alng with a cpy f yur birth certificate shwing yur name and their name. If this is a sibling, we will require bth yurs and yur siblings birth certificate shwing parents names. If yu wrk in the brugh, please frward an fficial letter frm yur emplyer cnfirming emplyment, place f wrk, salary and number f years emplyed. PHOTOGRAPHIC IDENTIFICATION: Please frward a cpy f ne f the fllwing: A valid driving license A valid passprt BANK STATEMENTS: Please frward cpies f yur three mnths mst recent bank statements fr all applicants. PROOF OF DEPOSIT: Please frward a cpy f the statement hlding the depsit yu have available.

6 Sectin 6 Declaratin bpha ltd will nly prcess the given persnal data f all applicants fr the purpse f prcessing yur applicatin fr husing and will hld yur infrmatin in accrdance with the Data Prtectin Act We may als share infrmatin fr same purpses with ther rganisatins that handle public funds. The infrmatin may be used fr statistical surveys, which means we may pass this infrmatin in cnfidence t the Department fr Cmmunities and Lcal Gvernment and agencies wrking n ur and their behalf wh may cntact yu. All infrmatin yu give us n this frm (and infrmatin resulting frm cntact with yur landlrd and/r emplyer) may be shared with the same nly in relatin t this applicatin. All infrmatin will be treated in the strictest cnfidence. bpha alng with, Help t Buy agents, lcal authrities and partner husing assciatins, reserve the right t take up any references related t the applicants as we cnsider it necessary and may als search the files f any credit reference agency which will keep a recrd f any such request. We must prtect the public funds we handle and s may use the infrmatin yu have prvided n this frm t prevent and detect fraud. Under the sectin 29 (3) f the Data Prtectin Act 1998 the infrmatin may be disclsed fr the purpses f crime preventin and detectin. Sensitive persnal data such as racial r ethnic rigin, ffences (including alleged ffences) and physical and mental disabilities are required under the Equal Opprtunities Mnitring statute. Declaratin: It is a criminal ffence t knwingly r recklessly make a false declaratin r withhld infrmatin reasnably required in cnnectin with yur applicatin. I/We have read the abve and cnfirm that I/we have prvided accurate and up-t-date infrmatin relating t my/ur applicatin. r I/ We understand that if it is fund that false infrmatin has been given t btain husing either knwingly r recklessly, apprpriate legal actin maybe taken by the husing assciatin r lcal authrity and/r seek pssessin f any leasehld tenancy granted. (Translatin service available if required) I/We understand that as a cuncil, husing assciatin r ther public sectr tenant, I will be required t give up my rented hme n the day f cmpletin if I buy r rent a hme thrugh any f the husing assciatins r lcal authrities ffering hmes. I authrise bpha Ltd t pass infrmatin t Help t Buy agents, husing assciatins, lcal authrities and ther partnering rganisatins, credit references agencies and t estate agents r new hmes develpers wh may be able t assist in lcating prperties fr applicants. I authrise Help t Buy agents & partner husing assciatins t cntact me by telephne, text, r by pst. Checklist Frm Fully Cmpleted Prf f Incme Supplied Prf f Cnnectin Supplied Bank Statements Supplied Phtgraphic Identificatin Supplied Prf f De[psit Supplied Applicatin Frmed Signed and Dated FIRST APPLICANT SECOND APPLICANT Signed: Date:

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