INTERMEDIARY SELF BUILD MORTGAGE APPLICATION FORM.

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1 Roll number INTERMEDIARY SELF BUILD MORTGAGE APPLICATION FORM. Stage 1 of 2 Please post this form to: Self Build Team Pentland House 8 Lochside Avenue Edinburgh Park South Gyle Edinburgh EH12 9DJ To receive a decision in principle and Mortgage Illustration it is essential that this form is fully completed by the Intermediary. TNT 065 halifax-intermediaries.co.uk

2 Intermediary information Halifax Panel Number (Internal use only) Your first name Your last name Company name Company address Company phone number Company fax number Company address Preferred address Alternative address s sent to and from Halifax are not secure and could be accessed by an unauthorised person. Whilst we take appropriate measures to safeguard information you provide to us, no can ever be guaranteed secure. This form should not be ed to us due to the sensitive nature of the information being collected. Any sent by the Halifax will be restricted to a minimum of application number and brief message including what is required to progress the application to the next stage. The Data Protection Act 1998 restricts the amount of information we can disclose in messages. Company FCA number Intermediary User ID Preferred payment route Broker declaration I confirm that I am acting on behalf of the applicant(s) and have their permission to access their information. I confirm that, to the best of my knowledge and belief, the information contained in this application is true. I confirm that this application is made in line with the Halifax Self Build policy and understand the application will be declined if it becomes evident this application does not meet the Halifax Self Build criteria. Broker signature Broker name (please print name) Date signed 1

3 Number of applicants Do you require a Mortgage Illustration from Halifax? Level of service for this application Level of service execution only rationale Advised High net worth Execution only Mortgage professional Rejected advice n-interactive sale Intermediary fees Fee type Amount of fee How much of the fee is refundable? When payable Fee 1 Fee 2 Fee 3 On application On application On application Within 14 days completion Within 14 days completion Within 14 days completion On cancellation On cancellation On cancellation On completion On completion On completion Personal details Applicant 1 Applicant 2 Title Mr/Mrs/Miss/Ms/Dr/Other Forename 1 as shown on id Forename 2 as shown on id (if applicable) Forename 3 as shown on id (if applicable) Surname Gender Male Female Male Female Date of birth Marital status Married/Civil partnership Widowed Single Divorced/ Dissolved Civil partnership Separated Married/Civil partnership Widowed Single Divorced/ Dissolved Civil partnership Separated Has your name ever changed? Date of name change Previous first name Previous middle name Previous surname How many dependent children do you have? Nationality Dual Nationality Country of residence Do you have diplomatic immunity?* Work telephone number 2 * Halifax do not accept applications where the customer benefits from diplomatic immunity.

4 Personal details (continued) Applicant 1 Applicant 2 Home telephone number Mobile number Preferred contact number Work Home Mobile Work Home Mobile Home address Work address Special needs Large print Braille Audio text Large print Braille Audio text Current address Correspondence address Residential status Home owner mortgage Renting Home owner mortgage Renting Has your address changed in the last 3 years? First previous address in last 3 years Home owner (mortgage free) Family/Friend Home owner (mortgage free) Family/Friend Date moved into previous address Date moved out of previous address Residential status Home owner mortgage Renting Home owner mortgage Renting Home owner (mortgage free) Family/Friend Home owner (mortgage free) Family/Friend Second previous address in last 3 years Applicant 1 Applicant 2 Date moved into previous address Date moved out of previous address Residential status Home owner mortgage Renting Home owner mortgage Renting Home owner (mortgage free) Family/Friend Home owner (mortgage free) Family/Friend 3

5 Money laundering Applicant 1 Applicant 2 Was the verification taken? Face to face n Face to face Face to face n Face to face Application identification Type of standard verification provided Document reference Date of issue Date of expiry Issuing office/organisation Applicant 1 Applicant 2 Type of secondary verification provided Document reference Date of issue Issuing office/organisation Customer information Applicant 1 Applicant 2 Customer type First time buyer Existing Halifax borrower First time buyer Existing Halifax borrower Home mover Home mover Remortgage from Birmingham Midshires? Do you have a current mortgage? Will you repay existing mortgage upon initial release of funds? Employment details Applicant 1 Applicant 2 Number of jobs per applicant Employment type PAYE Self-employed PAYE Self-employed What type of occupation are you in? e.g. Sales, office, professional, trades Contract type Permanent Probationary Permanent Probationary Piecework Sub-contract Piecework Sub-contract Seasonal/Temp Fixed/short term Seasonal/Temp Fixed/short term Agency Agency Start date of employment Percentage of business owned % % Anticipated age of retirement Type of anticipated retirement annual income Anticipated retirement annual income Frequency of anticipated retirement annual income Second type of retirement annual income 4

6 Anticipated retirement annual income Frequency of second anitcipated retirement annual income Name of employer/business Employer s/business address Employer s/business telephone number Employer s/business fax number Do you have income from any other sources? Income Gross basic salary Annual commission Annual bonus Annual overtime (If, please complete the Other Income section on page 6.) Can income be verified? Can income be verified? If self-employed Latest year Year end date Turnover () Gross profit () Net profit () Assets () Liabilities () Previous year Year end date Turnover () Gross profit () Net profit () Assets () Liabilities () 2nd Previous year Year end date Turnover () Gross profit () 5

7 2nd Previous year (continued) Net profit () Assets () Liabilities () Projected year Year end date Turnover () Gross profit () Net profit () Assets () Liabilities () What year did you acquire an interest in the business? In what year was the business established? Does the business have accounts? Name of accountant s firm Accountant s address Accountant s telephone number Name of previous employer/business Previous employer s/business address Previous employer s/business telephone number Previous employer s/business fax number What type of employment was this? e.g. Sales, office, professional, trades Start date of employment End date of employment Other income (If total employment history is still less than 18 months, please complete section 2 on page 10.) Applicant 1 Applicant 2 What type of income is this? Annual amount () What type of income is this? Annual amount () 6

8 Personal finances (both applicants) Switch/Visa debit card Visa/MasterCard Amex/Diners card Store card/other cards Current account Bank or other loan Savings account Applicant 1 Applicant 2 Time with bank Years Months Years Months Loan details Cost of land Total cost of build works Location of property Scotland & N.Ireland rth rth West South Wales & West Greater London South East Loan amount Estimated final value of property () Total value of cash incentives Amount of initial release () Source of deposit Builder/Seller Concessionary Equity Gift Tenants Incentive Scheme Savings Total value of outstanding mortgages with Lloyds Banking Group Provide breakdown of the mortgage required. Parts 2 and 3 are where multiple products, terms or repayment types are required. Loan details remortgage from Birmingham Midshires Original cost of land Cost of works to complete the build Current estimated final value of the property Amount of additional borrowing 10% of the original loan amount will be retained from the additional borrowing funds until we have completed a Final Inspection and are in receipt of the Completion Certificate. 7

9 Credit Commitments (these include Switch/Visa Debit card, Visa/MasterCard, Amex/Diners card, store cards, other cards, current accounts, bank loans, other loans, savings accounts, school fees, child care, student loans and second home running costs) Commitment 1 Commitment 2 Commitment 3 Commitment 4 Commitment 5 Type of commitment Whose name is commitment in? Name of lender/company Monthly repayment Balance outstanding End date of loan Number of months in arrears Will this be repaid on completion in full? If yes, source of funds to repay Total monthly maintenance payments For mortgage commitments only, complete the information below: Mortgage type Remaining term Repayment type Mortgage lender Monthly running cost Monthly payment Outstanding balance End date Current months in arrears Intend to repay upon initial release of funds? Source of repayment Have any future known changes to income/ expenditure been taken into account? If you have additional mortgage commitments complete section 3 on page 10. Financial history Has any applicant been in arrears in the last 6 years with any borrowing or ever had a property repossessed? Has any applicant had a County Court Judgment (CCJ) or default registered against them or if self-employed against their business within the last 6 years? Has any applicant been declared bankrupt, entered into an IVA or debt relief order within the last 6 years or still have an outstanding bankruptcy restriction order? 8

10 Product details Product code Part 1 Part 2 Part 3 SBL SBL SBL Type of product e.g. fixed, tracker Interest rate charged Product term/end date Loan amount Loan term (years) Repayment type Purpose Existing Halifax mortgage account number (if porting) Remortgage from Birmingham Midshires Only existing Halifax Self Build products can be ported on to a new Halifax Self Build mortgage. Only the additional borrowing can be put on to a new self build product as part of the remortgage to the Halifax. Existing product details will be ported on to the new Halifax mortgage account. Existing mortgage account number Existing mortgage debt What is your preferred payment date? What fees are to be added to the loan and not paid within 30 days of completion? Product fees Interest only amount Give details of new or existing plans or policies to be used with the interest only part of this mortgage Endowments Stocks & Shares ISA Unit Trusts/ Open Ended Investments Companies (UK) Investment Bonds Stocks & Shares Pensions Sale of other residential property Please also complete Interest only Other residential property form for each property. Total Monthly premium Reference/Account number Maturity date for each repayment vehicle Supporting information Section 1 Additional information on previous addresses If you want to provide any additional information to support your application, please use the section below. 9

11 Section 2 Additional information on current/previous employers Section 3 Additional information on mortgage commitments Mortgage type Remaining term Repayment type Mortgage lender Monthly running cost Monthly payment Outstanding balance End date Current months in arrears Intend to repay on completion Source of repayment Section 4 Any other information you feel we might need to know to help us assess your application for a mortgage, in particular, if the loan extends beyond retirement age. Please confirm how you intend to maintain payments. 10

12 THIS PAGE SHOULD BE READ AND RETAINED BY ALL CUSTOMERS Customer confirmation If I apply for a mortgage I confirm that I make the following statements: I declare that: I authorise you to: I agree that: I understand that: Data protection notice 1. I apply for a loan on the security of the property described in this application; 2. I believe the information given in this application is correct; 3. Make any enquiries of any third parties for reference purposes and for the third party to disclose any information to you; 4. Change the address on all my accounts held with members of your group of companies; 5. You and any subsidiary or associated company of yours, will retain commission paid or allowed on any insurance you arrange; 6. You may be provided, by the policy or plan provider, with any information relating to any life policy or investment plan being taken into consideration by you in connection with this mortgage; 7. I will notify you of any changes in circumstances relating to my purchase or mortgage before it is entered into and I authorise my conveyancer to disclose such information to you; 8. Where I am making this application with one other joint applicant (but not more than one other), following completion you may act on the request of either of us for a payment arrangement, payment holiday or the release of any retained funds or drawdown of reserve/credit available under the mortgage. I also agree that such a request may be made in person, in writing, by telephone or online. 9. If I borrow and do not repay in full and on time, you may tell credit reference agencies who will record the outstanding debt and my details may be submitted to the Council of Mortgage Lenders possessions register; 10. I have received information explaining property assessments; 11. I have received initial disclosure information and a Mortgage Illustration relating to this mortgage; 12. The payment of any fees is non-refundable and shall not mean that you have to make an advance; 13. If I/we choose a Homebuyer s Survey and Valuation Report, you will choose the valuer for the property assessment and that it is the valuer s responsibility to agree the Conditions of Engagement for the private survey element with me; 14. When considering an application for credit, you may use the information supplied to you to offer additional products. Your information will be held by Bank of Scotland which trades as Halifax, part of the Lloyds Banking Group. More information on the Lloyds Banking Group can be found at lloydsbankinggroup.com Your personal information will be shared within the Lloyds Banking Group so that we and any other companies in our Group can look after your relationship with us. By sharing this information it enables us to better understand your needs, run your accounts, and provide products in the efficient way that you expect. We will share your personal information from your application with fraud prevention agencies. If false or inaccurate information is provided and fraud is identified, details of this fraud will be passed to these agencies to prevent fraud and money laundering. Further details explaining how information held by the fraud prevention agencies may be used can be obtained by reading the privacy notice at halifax.co.uk or contacting your local branch. We may obtain information about you from credit reference agencies, fraud prevention agencies, and Group records to check your credit status and identity. The agencies will record our enquiries which may be seen by other companies who make their own credit enquiries. This may affect your ability to obtain credit elsewhere in the near future. We may also use credit scoring. Your application will be assessed using credit reference agency records relating to you and anyone with whom you have a joint account or similar financial association. If this is a joint application and such a link does not already exist then one may be created now. These links will remain until you successfully apply for a notice of disassociation at the credit reference agencies. 11

13 If you are providing information on behalf of a joint applicant, by continuing with this application you confirm that you have their permission to do so and they have agreed that we are authorised to search, link and record information about them at credit reference agencies. We may ask you to provide physical forms of identity verification when you open your account. Alternatively, we may search credit reference agency files in assessing your application. The agency also gives us other details and information from the Electoral Register to verify your identity. The agency keeps a record of our search, whether or not your application proceeds. Our search is not seen or used by lenders to assess your ability to obtain credit. Under the Data Protection Act you have the right of access to your personal data. The Act allows us to charge a fee of 10 for this service. If anything is inaccurate or incorrect, please let us know and we will correct it. Lloyds Banking Group companies may use your information to contact you by mail, telephone, or text message about products and services that may be of interest to you. If you do not wish to receive this information please contact your local branch or visit halifax.co.uk for details of how to opt out of this service. It is important that you understand how the personal information you give us will be used. Therefore, we strongly advise that you read our Privacy Statement, which you can find at halifax.co.uk/securityandprivacy/privacy.asp or you can ask us for a copy. By applying for a mortgage, you agree to your personal information being used in the ways we describe in our Privacy Statement. Please let us know if you have any questions about the use of your personal information. Remortgage customer authority (where applicable) 1. I authorise you or any conveyancers acting for you in connection with the proposed remortgage of my property: to obtain the title deeds to the property; to obtain a repayment figure from my/our current lender(s). 2. I confirm that I will make my own enquiries about and pay any fees or charges made by my current lender in connection with the repayment of my existing mortgage (including any administration fees made in respect of sending the title deeds to your conveyancer and providing a repayment figure and any fees in connection with my existing mortgage). 3. I understand that your conveyancer is only representing you and that if I want independent legal advice at any stage of this transaction I will obtain and get it myself. 4. I understand that you may not arrange for an inspection of the property to be carried out. I further understand that you will not routinely tell me what your assessment of the value of the property is. I understand that, if you are prepared to make me a loan, I must not rely upon any assessment made as an indication of the value of the property. You have informed me and I accept that, if I require any information about the value or condition of the property or about any health and safety issues, it is my responsibility to obtain independent advice before I go ahead with the remortgage of the property. Land Registry I authorise your conveyancer to obtain copies of any document held at any of the land registries in England and Wales, Scotland and rthern Ireland. 12

14 Halifax is a division of Bank of Scotland plc. Registered in Scotland. SC Registered Office: The Mound, Edinburgh EH1 1YZ. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Financial Services Register number Telephone calls may be monitored or recorded. 1/ (02/16)

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