more 2 life Interest Choice Plan customer application form

more 2 life Interest Choice Plan customer application form INSTRUCTIONS Please fully complete this form in black ink using BLOCK CAPITALS. Once completed please return to: more 2 life, PO Box 1168, Preston, PR2 0GB 1. Personal details If an attorney is signing this form, then the attorney s name and address should be noted in section 11. First Applicant Second Applicant Title Mr Mrs Miss Ms Other Mr Mrs Miss Ms Other Surname...... First name(s)...... Gender Male Female Male Female Date of birth... /... /...... /... /... Nationality...... Retirement Age Actual... Expected... Actual... Expected... Marital status...... Previous/Former name...... (e.g.maiden or any aliases or associations) Employment status: Employed Self employed Employed Self employed Retired Other Retired Other Current country of residence...... UK citizen Yes No Yes No Home address.................. County:... Postcode:... County:... Postcode:... Daytime telephone no....... Mobile telephone no....... Date moved into current address... /.../........ /.../... Email...... Residency type Owner Occupier Owner Occupier

1. Personal details (continued) Other occupants? Yes No If yes, please give details... Please provide details of anyone who is 17 years or over who is not a mortgage applicant, but will be living in the property. Name of dependents or other occupier(s) living in the property Relationship Date of birth Email......... /... /............... /... /...... Have you lived at your property for less than 3 years? Please provide details of any other addresses lived at within the last 3 years and how long each applicant has lived there. (Using Section 12 of this form if necessary)... Date at this address From:... To:...... Date at this address From:... To:... Number of dependent adults... Number of dependent children... This is based on financial dependency 2. Current and future financial details Please note that if this application is approved, it will be conditional that any existing mortgage, secured loan, charge, or pending charge secured against your property must be redeemed in full prior to, or on completion of this new loan. If you have more than one mortgage or secured loan outstanding, please provide full details in section 12. Please give details of all mortgages/secured loans. Lender s name & address........................ Postcode:... Postcode:... Loan reference no....... Outstanding balance...... Have you ever: (Tick as applicable. If Yes, please provide details below) First Applicant Second Applicant - entered into any arrangements with creditors due to financial difficulties, Yes No Yes No had any County Court Judgements or any other Court Orders for non-payment in the last 6 years or been convicted of (or have any pending convictions relating to) any criminal offence (excluding minor traffic offences)? - been party to a mortgage where the property has been taken into possession Yes No Yes No on either a voluntary or enforced basis? Have you ever had any of the following: Arrears Yes No Yes No (in the last two years the applicant has owed payments of an amount equivalent to three months payments on a mortgage or loan, whether secured or unsecured) Bankruptcy (in the last three years) Yes No Yes No Debt relief order (in the last three years) Yes No Yes No Individual voluntary arrangement (in the last three years) Yes No Yes No If you have answered yes to any of the above questions, please provide details in Section 12.

2. Current and future financial details (continued) Annual income If you are borrowing jointly, when assessing affordability we will assume that you will stop paying interest payments after one of you dies or enters permanent long-term care. At the time, the remaining borrower can choose to continue or stop paying interest payments. If you decide to stop, your lifetime mortgage will convert to a full interest roll-up basis. Type of income (net of income tax and NI contributions) Current Future (e.g. at retirement) Reason for change First Applicant Salaried earnings Self employed earnings Bonus State pension Private pensions State benefits Any other income (please state source in Section 12) Investments income Second Applicant Salaried earnings Self employed earnings Bonus State pension Private pensions State benefits Any other income (please state source in Section 12) Investments income We will only consider this application where we receive certified copies of documentation to evidence all income. For details of acceptable evidence see lending criteria. Joint annual expenditure Please provide a breakdown in Section 12 of the lender and current balance for each item of credit. Committed Current balance Current payments Payment after loan advance Future (e.g. at retirement) Mortgage/secured loans Interest-Only mortgage repayment Credit Cards Unsecured loans Credit/Hire Purchase Agreements Fines/County Court Judgements Alimony payments/child maintenance Savings (please state details in section 12) We will only consider this application where we receive certified copies of documentation to evidence all committed unsecured expenditure. For details of acceptable evidence please see our Lending Criteria.

2. Current and future financial details (continued) Basic essential Current payments Future (e.g. at retirement) Service charge or ground rent Water rates Council tax Electricity/other heating/gas Buildings/contents insurance Telephone/mobile/internet Housekeeping (food and washing) Fuel/essential travel/public transport (if commuting to workplace) Other (please state details in section 12) Basic quality of living Current payments Future (e.g. at retirement) Life/Medical/Accident Insurances Household goods (satellite/appliance rental/tv licence)/furniture/ repairs & maintenance Personal goods (toiletries) Pets/pet food/pet insurance Clothing/footwear Basic recreation (Television/basic recreational activities/ non-essential transport) Childcare Other discretionary expenditure (please state details in Section 12) 3. Interest payment An interest payment involves making monthly payments to cover some or all of the interest. Choosing to pay some or all of the interest during the lifetime of the plan reduces the amount owed when the mortgage is repaid. Total loan applied for:... Initial lump sum release... I wish to pay... interest each month. Please indicate the purpose of the money released: Home improvements Debt consolidation Other Please specify the amount of debt to be consolidated... 4. Payment of fees FEES PAYABLE BY YOU ON COMPLETION OF THE LOAN Set up Fee I want to add the Set up Fee to my loan I want to deduct the Set up Fee from my loan I want to pay the Set up Fee separately Funds Transfer Fee I want to deduct the Funds Transfer Fee from my loan I want to pay the Funds Transfer Fee separately I understand that interest is payable on any fees added to, or deducted from, the loan for the duration of the loan.

5. Property details THE PROPERTY ON WHICH THE LIFETIME MORTGAGE IS TO BE SECURED Is the property your existing home or a new purchase? Existing home New purchase If it is a new purchase please provide us with... the address:............ Postcode:... What is the estimated value of the property?... What year was the property built?... What type of property is it? House Flat Maisonette Bungalow Detached Semi detached Terraced Over or adjacent to retail or business premises? Yes No If yes, please give details in Section 12. If your property is a flat or Converted Purpose built Studio maisonette, please give details. No. of flats/maisonettes in block How many storeys? Which storey is it on? If a new purchase, is the property being purchased under the right to buy scheme Yes No Is the property ex-local authority/housing association? Yes No If yes, do the local authority still own the freehold? Yes No Please indicate the tenure: Leasehold Freehold Absolute Commonhold If leasehold, please state remaining term years What is the property built of? Brick Stone Timber frame Other (please state) What is the property roofed with? Tile Slate Flat Other (please state) Is your property currently let? Yes No Has there been any structural damage? Yes No Is it classed as sheltered accommodation? Yes No Has the property been underpinned? Yes No Are there any age restrictions placed on Yes No If yes, are guarantees available? Yes No the occupants of the property? If yes, please specify overleaf.

5. Property details (continued) Will you use the property wholly for Yes No Has the property or surrounding area been Yes No residential purposes? affected by subsidence, heave, settlement, If no, please specify below. landslip or flooding? Is the property subject to any agricultural Yes No restrictions? If yes, please specify below. Additional details: Valuation more 2 life will need to obtain a valuation of your property which should not be relied upon by you as a report on the condition of the property. We will contact you to arrange the valuation. If you are not already the owner of the property please supply the contact details of the person we can contact to make valuation arrangements in section 12. Building insurance The property must be insured by you. A copy of the policy certificate, noting more 2 life, will be asked for in due course. 6. Repayment strategy Yes No Is it your intention to repay the loan from the sale of your property on your death or on the death of the last borrower or if you, or the last of you when more than one borrower, have left your home permanently eg. if you move into long-term care or to be cared for by relatives. Please provide details in the box below 7. Solicitor details more 2 life will appoint its own solicitor to represent it in the transaction. You will need to appoint a firm to represent you. Please provide the name and address of the solicitor who will be acting for you in connection with this mortgage application. Name of acting solicitor... Name of firm... Address of firm......... Postcode... Tel no inc. STD code... Fax... Email address...

8. Debit/Credit card details FOR PAYMENT OF APPLICATION (INC.VALUATION) FEE AND SET UP FEE (IF APPLICABLE) Debit/Credit Card type e.g. Maestro, Delta, Visa, Mastercard etc... Debit/Credit Card no... Issue no. (Maestro only)... Start date:... Expiry date:... Card holder(s) name(s)... I/we authorise more 2 life to debit my/our Debit/Credit Card(s) with the following (please see Key Facts Illustration,Section 11 for latest fees): Application inc. valuation fee Please note: In the event that you do not proceed,the application fee will be deducted from this card. Signature of card holder(s) x Date:... /... /... more 2 life will contact you with regard to this transaction and explain any fees. 9. Direct Debit guarantee This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits. If there are any changes to the amount, date or frequency of your Direct Debit Just Retirement Ltd will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request Just Retirement Ltd to collect a payment, confirmation of the amount and date will be given to you at the time of the request. If an error is made in the payment of your Direct Debit by Just Retirement Ltd or your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society. If you receive a refund you are not entitled to, you must pay it back when Just Retirement Ltd asks you to. You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us. Direct Debit authorisation FOR MONTHLY INTEREST PAYMENT Instruction to your Bank or Building Society to pay by Direct Debit. Please complete all the details below. The Just Retirement Ltd team will pass these on to your bank so they can set up the payments. Name and full postal address of your Bank or Building Society. To: The Manager...... Bank/Building Society Address:............ Postcode:... Instruction to your Bank or Building Society Please pay Just Retirement Ltd from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with Just Retirement Ltd, and if so, details will be passed electronically to my Bank/Building Society. Signature(s): x x Date: / / Name(s) of Account Holder(s)...... Bank/Building Society Account Number Branch Sort Code (top right-hand corner of your cheque) FOR OFFICE USE ONLY Originator s Identification Number Reference Number 4 3 7 9 7 5 more 2 life, PO Box 1168, Preston, PR2 0GB

10. Declaration Use of Information and the Data Protection Act We need to collect information about you so that we can understand your circumstances, requirements and for certain other specified purposes. This section tells you why we ask for information, who we provide it to, the purposes that it may be used for and explains how we will protect your privacy. Compliance with data protection law We are conscious of our responsibilities under the Data Protection Act 1998 and will ensure that the information you provide to us will always be processed and transferred in compliance with all applicable data protection laws and regulations. What information we may obtain We may obtain a variety of information about you that may include (but is not limited to) information relating to your financial circumstances (for example, your income, outgoings and existing investments), gender, dependants and marital status. We may also ask you about sensitive data such as your physical and mental health. Collecting this information may assist us to provide you with a tailored service. Any information that is received about you may be retained for at least 6 years. Your rights The Data Protection Act 1998 gives you the right to see any personal data that we hold about you. We may charge you a small fee for providing this information but it will not exceed any prescribed statutory limit. You have the right to require any inaccuracies in personal data relating to you to be corrected. You have the right to prevent processing of sensitive and personal data for the purposes of direct marketing. Sharing and use of your information Any information received about you (either directly or from third party) as a consequence of providing equity release advice, information or solutions may be used by us (for purposes 1-8 below) or passed by us to any providers of equity release schemes (for purposes 1-8 below), our suppliers (for purposes 3, 5 and 7 below), to anyone who purchases an interest in us or any of our group companies (for purposes 4-6 below) and to our group companies (for purposes 4-7 below) for the following purposes: 1. For the administration and continuing review of your plan; 2. To provide you with information about the products you have taken out; 3. To perform credit checks and verify your identity; 4. To comply with legal and regulatory obligations; 5. For business analysis and research; 6. To provide you with information about products and services that may be of interest; 7. For general administrative purposes, including the storage and backup of data. 8. We may also need to share information with your adviser. Any credit reference check may affect your credit rating. To complete our processes we may have to share your information with Just Retirement. This information will not be used for any other purpose. Data Protection principles We adhere to the eight principles set out in the Data Protection Act. These state that information must be: Fairly and lawfully processed Processed for limited purposes Adequate, relevant and not excessive Accurate and up to date Not kept for longer than is necessary Processed in line with individuals rights Secure Not transferred to other countries without adequate protection. We will also attempt to electronically verify your identity and the identity of any relevant attorney(s), by searching the files of credit reference agencies who will record any credit searches on your file and the file of your attorney(s). This information will be used to assist in fraud prevention, underwriting, money laundering checks, and may be passed in confidence to third parties for regulatory reporting, audit, debt collection or the resolution of complaints. Questions? If you have any questions regarding our use of your data or you wish to update your details or require a copy of your personal data that is held by us, then please write to the Data Protection Department, more 2 life Limited, P.O.Box 1168, Preston, PR2 0GB. A fee (not exceeding the statutory maximum) may apply. Customer Declaration I/We consent to more 2 life Limited holding and processing my personal data (including my sensitive personal data) as set out in this section. If, however, you would rather that your information is not used for purpose 6 set out above, please let us know by ticking this box: If you would like to be contacted by electronic means including telephone, fax, e-mail, text message for direct marketing purposes, please let us know by ticking this box: Please read the following carefully before signing and dating your application All details provided are true and accurate to the best of my/our knowledge and belief, and I/we understand that these details will form the basis of the contract between myself/ourselves and more 2 life. I/We will inform more 2 life immediately if any of the information on this form changes before completion of the mortgage. I am/we are permanently resident in England and Wales. I am/we are 60 years or older (or will be 60 years old within the next 3 months). I/We have received a copy of the Key Facts Illustration and understand the nature of this mortgage loan and the potential implications of entering into this arrangement. I/We will pay the application fee which includes the valuation fee and this can be paid by cheque or can be debited from my/our debit/ credit card(s). The valuation will not provide a structural report and if this is required, I/we will be liable for this expense. Payment of the application fee does not guarantee approval for an equity release plan. Upon completion of the loan, any set up fee not paid at the time of the application will be deducted from the money sent to our conveyancer.

10. Declaration (continued) I/We will pay the monthly interest payment by Direct Debit. I/We understand that if four interest payments are missed (these do not have to be consecutive), the loan will revert to a roll-up loan. Any drawdown loans will already be rolling up and so are not affected by this. I/We understand that if I/we choose to stop making interest payments the loan will revert to roll-up. Any drawdown loans will already be rolling up and so are not affected by this. Any offer or acceptance of an equity release plan does not imply a warranty as to the condition or construction of the property. I/We give authority to the current mortgage lender(s) to disclose full details of my/our mortgage to any conveyancer acting for more 2 life (the Panel Conveyancer), to provide the Panel Conveyancer with a redemption statement or statements, other necessary information and the property title deeds. I/We will be liable for any costs associated with the provision of this information or documentation and that we should make our own enquiries about any fees which my/our existing lender may charge. I/We have read the notice regarding the use of my/our personal information and agree to the use of my/our personal information as outlined. more 2 life will arrange a Mortgage Valuation Report for more 2 life to consider this application. It is not intended to be a detailed inspection of the property. Neither more 2 life nor its valuer will provide a warranty as to the condition or value of the property. more 2 life may decline the application and need not give a reason for doing so. I/We accept that by proceeding with this application I/we will be entering into a legal agreement with more 2 life. more 2 life and Just Retirement will register an interest in your property with HM Land Registry. I/we agree that more 2 life can transfer the loan, mortgage and other security for the loan should more 2 life wish to do so. more 2 life may give information and documents relating to me/us and my/our loan, my/our property and the conduct of the loan to any transferee or potential transferee. By signing this application form I/we agree that any person interested in the loan now or in the future may rely on the information in this application form and any supporting documentation, information or security. Any non-disclosure or misrepresentation may result in legal action and/or repayment of the lifetime mortgage. more 2 life may request additional information it thinks is reasonably needed to decide whether to lend to you. If there is any further information that could affect more 2 life s decision to approve the loan that has not already been made known within the course of completing the application please tick this box Please provide further details in Section 12. As a provider of an Equity Release Council approved plan, we are responsible for ensuring that you received advice in relation to this plan. Please check that the following statements are true before signing the declaration. Your adviser fully explained and documented: The financial implications of this plan and the effect on my/our estate, personal tax and how to find out about entitlement to state benefits. Alternatives to equity release, such as downsizing or delaying action. The pros and cons of the plan in relation to my/our health. That independent legal advice is required in relation to the plan. That it is recommended to involve family/beneficiaries in my/our decision. That maintenance costs and outgoings related to the property will continue to be my/our responsibility. That I/we can remain in our home for as long as I/we wish, and can move to a suitable alternative property in the future. That I/we should not rely on the proceeds from this equity release plan until it has completed and the funds have been received. Why this plan is suitable, providing a Key Facts Illustration, product literature and a written explanation of the suitability of the plan. That I/we agree to keep the property fully insured until the loan is repaid. That the mortgage will be administered as an interest only loan in accordance with the lifetime mortgage scheme. In the event that you do not proceed,the application fee will be deducted using the card details provided. By signing this declaration I/we am/are allowing you to process my/our application using the information that I/we have given. Signature section: You are signing to confirm that the information provided is true and accurate to the best of your knowledge. You are confirming your acceptance of section 10. An incomplete form may delay the processing of your application. To help us process your application quickly please check: 1. Have you authorised more 2 life to debit the application fee from your Credit/Debit Card? (Section 8) 2. Have you completed and signed the Direct Debit mandate, authorising Just Retirement Ltd to take monthly interest payments? (section 9) 3. Have you (both) signed and dated the declaration? (below) Please do not enclose copies of any illustrations issued to you.you must retain these for future reference. First applicant/attorney Second applicant /Attorney Full name:... Full name:... Signature: Signature: Date:... /... /... Date:... /... /...

11. Intermediary section TO BE COMPLETED BY THE INTERMEDIARY LOOKING AFTER THE APPLICATION You should be aware that more 2 life is unable to process applications from Intermediaries who are not authorised by the Financial Conduct Authority to carry out mortgage business. You confirm that in submitting this application you have read and agree to the Terms and Conditions of the more 2 life Intermediary Agreement, a copy of which has been sent to you on appointment. Key Facts Illustration Ref Number:... Your name:... Full company name and contact details:... Tel no. inc std code:...... Fax no:... County:... Postcode:... Email address:... Your firm s FCA reference number:... The following must be fully completed to help us comply with our obligation under the Mortgage Conduct of Business Rules (MCOB): Level of service relating to the lifetime mortgage provided to the customer(s). Please tick to indicate that advice has been given. Advice given and a recommendation made that the customer(s) apply for the lifetime mortgage product indicated (advised sale) Please disclose any fee payable by the customer(s) for advising on or arranging this lifetime mortgage Confirmation of verification of identity and age: Applicant 1 Applicant 2 Attorney Full name of customer(s)/attorney......... Current address......... Previous address if the individual(s) has changed in the last 3 months..................................... Date of birth... /... /...... /... /...... /... /... Means of age verification......... (Please refer to more 2 life if there is insufficient space to accommodate all the attorney details) I/We confirm that a) the information above was obtained by me/us in relation to the customer(s)/attorney(s) b) the evidence I/we have obtained to verify the identity of the customer(s)/attorney(s) Tick only one 1. Meets the standard evidence set out within the guidance for the UK Financial Sector issued by JMLSG; or 2. Exceeds the standard evidence (written details of the further verification evidence taken are attached to the confirmation) I confirm that the information provided (including details of FCA Authorisation) are correct. I confirm that I have passed an appropriate approved examining board s specialist examination in equity release and that I have provided supervised (tick as appropriate) the equity release advice and recommendation. Signed Date:... /... /... Name... Name of regulated firm... FCA reference number...

12. Additional Information

For office use only KFI reference number Reference number Advised sale Print name Signed Date:... /... /... more 2 life Limited PO Box 1168 PRESTON PR2 0GB t: 08454 150 150 f: 08451 260 060 e: info@more2life.co.uk w: www.more2life.co.uk more 2 life Limited is authorised and regulated by the Financial Conduct Authority. CML103