Lifetime Mortgage. In this application form, references to we, us and our are references to NRAM plc and includes our successors or assigns.

Lifetime Mortgage In this application form, references to we, us and our are references to NRAM plc and includes our successors or assigns. Existing Mortgage Account Number Key Facts Illustration Number For office use only Advice Execution-only BNA0232 V10 Version: 04/2014

We aim to make it as easy as possible for you to transfer your existing mortgage to a new property, so please read the following notes before you start. If you have any questions, our staff will be pleased to help you. Our helpline number is 0845 609 9610* *Lines are open Monday to Friday 8:30am-5:30pm (excluding bank holidays). Calls are charged at your service provider s prevailing rate and may be monitored and recorded. Important customer information: This application form must only be used if you are applying to port your Lifetime Mortgage. If you would like to apply to port any other type of mortgage product please contact us to request the appropriate application form Please complete this form in black ink using BLOCK LETTERS and by ticking or deleting answers as appropriate To help us process your application quickly please ensure the correct information is provided If you have any difficulties in completing this form please contact a member of our staff Please note that we cannot process your application until this form, and the Valuation/application fee are received by NRAM plc Alternative format: If you require this in an alternative format such as Braille, audio tape, large print or interpreter services, please call our Dedicated Team on 0845 609 9610 or you can contact us at disability.awareness@n-ram.co.uk. These contact details should not be used for general enquiries relating to your account. 1

For Intermediary/Adviser use only You should be aware that we are unable to process applications from Intermediaries who are not authorised or exempt by the Financial Services Authority to carry out mortgage business. You, the Intermediary, confirm that in submitting this application you have read and agree to the terms and conditions of our Intermediary Agreement, a copy of which has been sent to you or provided on appointment and which can also be accessed in the Intermediary Useful Downloads section of NRAM plc s website www.nram.co.uk FOR FINANCIAL CONDUCT AUTHORITY REGULATED MORTGAGE CONTRACTS The following must be fully completed to help us to comply with our obligations under the Financial Conduct Authority s (FCA s) Mortgages and Home Finance Conduct of Business (MCOB) Rules. Level of service a b c I/We confirm that advice has been given and a recommendation made that the customer(s) apply for the Lifetime Mortgage product indicated (Advised Sale) I/We confirm that no advice has been given to the customer(s) applying for the Lifetime product indicated (Execution-only sale) I confirm that I have passed an approved examining board s specialist examination in Equity Release and I am competent in the provision of advice on Equity Release in accordance with the Financial Conduct Authority s training and competence rules. I have provided the Equity Release advice and recommendation on this case (or the advice and recommendation on this case has been checked by an appropriately qualified and competent supervisor) Fees d e f The customer(s) has/have paid or will pay the above named Intermediary/Firm/Club a fee of When is this due to be paid, or when was it paid? Where a refund of all/part of these fees is due, please tell us how much will be refunded to your client(s) following completion of this Lifetime Mortgage and state the circumstances in which this would happen / / g The above named Intermediary/Firm/Club will pass on to the customer(s) all/part of any procuration fee it expects to receive from us. The total amount that will be passed on is: Intermediary details Signature Name Position Firm name and address Telephone Fax Email NRAM plc Panel P number Mortgage Club Reference Firm s FCA ref. number Principal s/network s FCA ref. number (for standard mortgages if you are an Appointed Representative) 2

CUSTOMER VERIFICATION FORM (for Brokers use only) 1 Name of Applicant 1 (Complete the reverse side for Applicant 2) of Birth 2 Current Address I certify that the application is Face to Face n Face to Face Mortgage Reference Number Face to Face customers are those who have been interviewed in person. One item of evidence to prove their Personal Identity and one to prove their address, taken from the list below, will be required. n Face to Face customers are those who have never been personally interviewed. In addition to the requirements outlined above, one additional item of evidence, taken from the list below will also be required. A Evidence of personal identity Reference/Account/ Serial Number Issuing Authority (3) Place of Birth of Birth of Expiry Certified copy attached (2) 1 Current Full Signed Passport (4) 2 Resident Permit issued to EU Nationals by the Home Office Country of Origin 3 Disabled Persons Parking Permit (6) 4 Current UK/EU Photo Driving Licence (1) 5 Current Full UK Driving Licence (old style) (1) of Issue 6 Firearms Certificate (1) 7 State Pension or Benefits Book/ tification Letter (1) 8 Sub-contractors Certificate 9 Inland Revenue Tax tification (1) National Insurance. Self Assessment Return tice of Coding B Evidence of current address Reference/Account/ Serial Number Name of of Issue Certified copy attached (2) 1 Most Recent Mortgage Statement Lender 2 Current Local Authority Tax bill Authority 3 Current Local Authority Rent Card or Tenancy Agreement 4 Bank/Building Society/Credit Union Statement or Passbook (5) 6 Utility Bill (not mobile phone) (5) 7 Current UK/EU Photo Driving Licence (1) 8 Current Full UK Driving Licence (old style) (1) 9 State Pension or Benefits Book/ tification Letter (1) 10 Firearms Certificate (1) Authority Issuer Utility 11 Inland Revenue Tax tification (1) National Insurance. Self Assessment Return tice of Coding tes: (1) These items may be used to evidence address or identity but not both. (2) If attaching certified copies of the evidence please also record the relevant details on this sheet as this will help with record keeping in the event that copy documents become detached from the certificate. (3) Enter the country of origin or the three letter code of the issuing state or country (i.e. UK passports enter GBR). (4) If the passport is non British a certified copy must be attached. (5) Documents must be either current or dated within the last 3 months. (6) This must be the blue badge as the orange badges without an expiry date are no longer valid. 3 I CERTIFY THAT I have verified the identity and address of the Applicant named above and having: a) seen the original documents; b) checked that any requiring a signature were pre signed; and c) confirmed that any associated photograph of the applicant bore a good likeness to the applicant, have included the relevant reference information or certified documentary evidence on/with this certificate. Signature* Name Position Telephone Company Address FCA Ref. * N.B. This certificate must be signed by the person who has seen the original documentary evidence.

CUSTOMER VERIFICATION FORM (for Brokers use only) 1 Name of Applicant 2 of Birth 2 Current Address I certify that the application is Face to Face n Face to Face Mortgage Reference Number Face to Face customers are those who have been interviewed in person. One item of evidence to prove their Personal Identity and one to prove their address, taken from the list below, will be required. n Face to Face customers are those who have never been personally interviewed. In addition to the requirements outlined above, one additional item of evidence, taken from the list below will also be required. A Evidence of personal identity Reference/Account/ Serial Number Issuing Authority (3) Place of Birth of Birth of Expiry Certified copy attached (2) 1 Current Full Signed Passport (4) 2 Resident Permit issued to EU Nationals by the Home Office Country of Origin 3 Disabled Persons Parking Permit (6) 4 Current UK/EU Photo Driving Licence (1) 5 Current Full UK Driving Licence (old style) (1) of Issue 6 Firearms Certificate (1) 7 State Pension or Benefits Book/ tification Letter (1) 8 Sub-contractors Certificate 9 Inland Revenue Tax tification (1) National Insurance. Self Assessment Return tice of Coding B Evidence of current address Reference/Account/ Serial Number Name of of Issue Certified copy attached (2) 1 Most Recent Mortgage Statement Lender 2 Current Local Authority Tax bill Authority 3 Current Local Authority Rent Card or Tenancy Agreement 4 Bank/Building Society/Credit Union Statement or Passbook (5) 6 Utility Bill (not mobile phone) (5) 7 Current UK/EU Photo Driving Licence (1) 8 Current Full UK Driving Licence (old style) (1) 9 State Pension or Benefits Book/ tification Letter (1) 10 Firearms Certificate (1) Authority Issuer Utility 11 Inland Revenue Tax tification (1) National Insurance. Self Assessment Return tice of Coding tes: (1) These items may be used to evidence address or identity but not both. (2) If attaching certified copies of the evidence please also record the relevant details on this sheet as this will help with record keeping in the event that copy documents become detached from the certificate. (3) Enter the country of origin or the three letter code of the issuing state or country (i.e. UK passports enter GBR). (4) If the passport is non British a certified copy must be attached. (5) Documents must be either current or dated within the last 3 months. (6) This must be the blue badge as the orange badges without an expiry date are no longer valid. I CERTIFY THAT I have verified the identity and address of the Applicant named above and having: a) seen the original documents; b) checked that any requiring a signature were pre signed; and c) confirmed that any associated photograph of the applicant bore a good likeness to the applicant, have included the relevant reference information or certified documentary evidence on/with this certificate. Signature* Name Position Telephone Company Address FCA Ref. * N.B. This certificate must be signed by the person who has seen the original documentary evidence. 4

MORTGAGE APPLICATION 1 Personal details 1 Title e.g. Mr, Mrs, Miss, Ms, Dr, Rev, other 2 First names First applicant Second applicant 3 Surname 4 Previous surname 5 Previous title e.g. Mr, Mrs, Miss, Ms, Dr, Rev, other 6 of birth 7 Current address 8 If this application is for the purchase of a new property, what are you going to do with your existing property? ( ) Selling Letting t selling Transfer of title Already sold N/A Selling Letting t selling Transfer of title Already sold N/A 9 moved into current address / / / / 10 Sale Price 11 Correspondence address if different 12 Reason for different correspondence address 13 Current residential status ( ) Owner Other, please provide details below Owner Other, please provide details below 14 Home telephone number 15 Work telephone number Code Code Code Code 16 Can we call you at work? ( ) 17 Mobile telephone number 18 If less than 3 years at current address give previous address(es) (If more than one, please use the additional information sheet Section 10.) Code Code 19 moved into previous address / / / / 5

1 Personal details (continued) First applicant Second applicant 20 Previous residential status ( ) Owner Other, please provide details below Owner Other, please provide details below 21 If, state country of residence 22 Sex ( ) Male Female Male Female 23 Marital status ( ) (Where the applicant is married, cohabiting or a civil partner, the mortgage application and the ownership of the property must be in the name of both parties.) 24 Do you have any unspent dishonesty convictions or a fraud related criminal record? ( ) 25 Do you have any dependents? ( ) Dependents are people who rely on you for housing; for example your children, parents or siblings 26 If, how many? Single Divorced Married Widowed Separated Civil Partner Single Divorced Married Widowed Please provide details of everyone who is either dependent on the applicant(s) or who will be living in the property upon which the loan is to be secured. Separated Civil Partner 27 If, please give their name(s), date(s) of birth and relationship to you. A Full name Relationship to applicant(s) of birth / / / / B Full name Relationship to applicant(s) of birth / / / / C Full name Relationship to applicant(s) of birth / / / / 2 Employment details Employment Status ( ) First applicant Second applicant Employed Self- Employed Retired Employed Self- Employed Retired Other (please specifiy) Other (please specifiy) 3 Court judgements/decrees/insolvency/bankruptcy/credit defaults Have you ever been insolvent, bankrupt, sequestrated, made arrangements with your creditors or been involved in any court proceedings for debt in the last 6 years? ( ) If yes please give details (including how many County Court Judgments or Bankruptcy Undertakings, if any) on the additional information sheet at the back First applicant CCJ Bankruptcy/insolvency/ sequestrated Credit defaults Have you had a property repossessed? Second applicant CCJ Bankruptcy/insolvency/ sequestrated Credit defaults Have you had a property repossessed? 6

4 Loan required Please provide details of the existing lifetime mortgage account number Loan repayment method: The Lifetime Mortgage will be administered on an interest rolled up basis with no mortgage payments due during the period of the loan. The Lifetime Mortgage will only be repayable under the circumstances described in your Key Facts Illustration. Lifetime Mortgage Cash Plus (lump sum/monthly cash release) Initial lump sum required and Monthly cash release required Details of your Bank Account nominated to receive monthly cash release amounts after the initial release (this must be a current account capable of receiving BACS (Bankers Automated Clearing Services) payments). Name(s) of account holders Bank account number Bank sort code Bank address 5 Property purchase details Purchase price Please give details of the source of the funds for the difference between the purchase price and the loan amount If you are borrowing funds other than for the purchase of the property please state the amount and purpose Amount Source te: second charges are allowed with this product 7

6 Property details (the property on which the Lifetime Mortgage is to be secured) Address of the property What type of property is it? House Flat/Maisonette Bungalow Other Detached Semi-Detached Terraced Number of Garages If the property has allocated parking is it off-site or on-site? On Off If the property is a flat or maisonette, please give details Is the property. of Flats/Maisonettes in Block Converted Purpose Built How many Storeys Studio Maisonette Does the property have a lift? Does the property have deck access? Is it a former or current Local Authority,rthern Ireland Housing Executive or Housing Association flat? If YES, what is the approximate percentage of owner occupation in the block? Is the property over or adjacent to retail/business? Construction type of the walls % Stone/Brick If YES, please give details in Section 10. Timberframe Other What is the roof made of? Slate/Tile Other What type of roof does it have? Flat Pitched Other Accommodation (Enter number in each box) Living Rooms Bedrooms Kitchens Bathrooms Toilets Outbuildings Other (please specify) Please indicate the tenure Leasehold Freehold Absolute Owner (Scotland) If leasehold please state Remaining Term years Ground Rent per annum In which year was the property built? Is the property classed as sheltered accommodation? Are there any age restrictions placed on the occupants of the property? If YES please specify Is the property a former or current Local Authority, rthern Ireland Housing Executive, Ministry of Defence or Housing Association Property? (former) (former) In which year was the property purchased? 8

6 Property details (the property on which the Lifetime Mortgage is to be secured) (continued) Is any part of the property let or tenanted? Will you use the property wholly for residential purposes? If NO please specify Will at least 40% of the total of the land being given as security be used either as, or in connection with, a residential dwelling? If NO, please give details in Section 10. 7 Valuation MORTGAGE VALUATION REPORT We will need to obtain a Mortgage Valuation Report. This is a limited report and is not a survey of the property. It is prepared solely for our purposes and as such should not be relied on by you as a report on condition. Where the report is made by someone who is not a NRAM plc employee/valuer, that valuer is responsible to you for the contents of the report. If you require, we can introduce you to firms of chartered surveyors that you can instruct to carry out a more detailed Homebuyers Survey and Valuation, or a Building Survey. This may be appropriate if you are buying a property. If you require either of these two more detailed reports please indicate below: Mortgage Valuation Report Homebuyers Survey and Valuation Building Survey NOTE: If you have not indicated that you require details of either a Homebuyers Survey and Valuation or Building Survey, we will process this mortgage application on the basis of a Mortgage Valuation Report. If you are not already the owner of theproperty, please give the name, address and telephone number of the person we can contact to make arrangements for the valuation. If this person is not the owner of the property please give details Please state the names and telephone number of any selling agent Telephone PURCHASES IN SCOTLAND Where a valuation of this property has already been carried out, what was the cost of this valuation? Who carried out the report? Telephone The type of report was: Mortgage Valuation Report Homebuyers Survey and Valuation Building Survey Your valuation/application fees can be paid by cheque (we no not accept debit, credit card or cash payments). Please note that we cannot process your application or instruct valuation until the cheque is received by us. If you re paying by cheque, please make it payable to NRAM plc and enclose it with your application. 8 Property Insurance THIS SECTION MUST BE COMPLETED Please tick the appropriate box and provide details and evidence of the cover to your solicitor Evidence of suitable property insurance must be provided before completion of your loan Arranging own insurance Insurance arranged by freeholder (leasehold/commonhold only) 9

9 Solicitor/licensed conveyancer details We will appoint our own solicitor to represent us in the transaction. You will need to appoint a firm to represent you. Name and address of the solicitor/ licensed conveyancer who will be acting for you in the connection with this mortgage application Name of acting solicitor Telephone Fax. 10 Additional information (please use this section to expand on incomplete answers given elsewhere in this form) 10

11 Declarations YOU AGREE AND DECLARE THAT: 1. This mortgage will be administered as a pure interest only loan in accordance with the terms of the Lifetime Mortgage scheme. You have received a copy of the Key Facts Illustration and understand the nature of this type of mortgage loan and the potential implications of entering into this arrangement. You have been advised to notify and consult with any other person(s) who may have an interest in the property offered as security for this mortgage. 2. A Mortgage Valuation Report will be arranged by us. You understand that this report is intended solely for the purpose of us in considering this application for a loan and is not intended to be a detailed inspection of the property. 3. Neither we nor the valuer gives any warranty as to the condition or value of the property and that it is for you to satisfy yourself as to the value and condition of the property. If you require, we can introduce you to firms of chartered surveyors that you can instruct to carry out a more detailed Homebuyers Survey and Valuation, or a Building Survey. 4. You agree to keep the property fully insured until the loan is fully repaid. 5. You are over 60 years of age. 6. You apply for a loan to be made on the security of the property according to the terms & conditions applicable to the Lifetime Mortgage and have enclosed a cheque for the valuation/application fee. Whether or not a loan is made you will meet the cost of the valuation. 7. You accept that one of the terms of applying for a loan is that we need not give any reason for declining the application. 8. You will not let the property without our prior written consent. 9. You agree that where a monthly cash release has been requested that it will be sent to the bank account nominated in Section 3B. 10. You accept that the written consent of all applicants will be required to change the bank account nominated in Section 3B. 11. You authorise NRAM plc or any solicitor/licensed conveyancer appointed by us to obtain account information (including repayment figures) from your lender. Using Your Personal Information: The personal information you supply to us as well as information we already hold, may be used in a number of ways, for example: To assess and process this and future applications; To verify your identity; To prevent fraud and money laundering; To manage your account(s); For management of arrears and debt collection; For audit purposes, research and statistical analysis; and To identify other products and services which might be suitable for you (with your consent). (a) We may share your information with, and obtain information about you from, credit reference agencies or fraud prevention agencies as outlined above. This may include details of any previous or subsequent names. (b) If false or inaccurate information is provided and fraud is identified, details will be passed to fraud prevention agencies to prevent fraud and money laundering. For further details as to how your information held by fraud prevention agencies may be used please see below. (c) We may seek appropriate references we consider necessary in respect of this application. You will meet the costs for this. (d) In addition to the above we will not ordinarily disclose information to other organisations (including subsidiaries of ours) except to help prevent fraud, where we are required by law, permitted under the Data Protection Act or in order to process your application. Where we pass on information, this will be treated with the same degree of care. (e) In order for us to offer you the best levels of service, we would like to provide you with information from time to time about products and services by post, fax, telephone, email or other electronic means. This may include other firm s products although we will not disclose your information to them. Please tick here if you do not wish to receive this information. You consent to us: giving any information in this application to the persons or bodies set out below; obtaining any information relating to this application from those persons or bodies; giving to, or receiving from, the persons or bodies set out below, any information about the conduct of your account (whether or not in default). The relevant bodies or persons are: (i) one or more credit reference agencies (which will retain a record of the search). (ii) insurance companies. (iii) The Council of Mortgage Lenders Possessions Register (iv) Operators of fraud prevention systems accessed by other lenders all of whom may in turn make it available to other lenders and insurers for the purpose of assessing further application for credit or other financial services, by you and members of your household and for occasional debt tracing arrears management and fraud prevention (v) Any person acting as or on behalf of any guarantor We may use your information to make credit scoring decisions. To enable us to do this we may make enquiries about you with licenses credit reference agencies who will keep a record of the search. This information may be shared with other lenders for the purposes of making lending decisions about you and for occasional debt tracing and fraud prevention. We may from time to time be required to process personal data about you which the Data Protection Act 1998 defines as sensitive, such as health data or criminal convictions. By providing this data you signify your consent to such data being processed by NRAM and its service providers and agents for the above purposes. You declare that you are entitled to disclose information about all applicants and/or anyone else referred to by you and authorise us to search, link and/or record information at credit reference agencies about you and anyone else referred to by you. 11

11 Declarations (continued) For further information on how your information may be used by credit reference agencies, fraud prevention agencies, and ourselves, contact: Freepost RTAE CJUZ KZGK, NRAM Mortgage Operations, PO Box 625, DURHAM DH1 9JJ. You can obtain a copy of the information we hold about you (for a fee) by writing to the above address. You also have a right to have any inaccuracies deleted or corrected. 12. You understand that we may transfer or otherwise dispose of the benefit of the proposed loan, mortgage and other security for the loan to any person without further reference to you. By signing this application form you will be giving your general consent to us to transfer or otherwise dispose of the proposed loan, mortgage and other security for the loan should we so wish. 13. You understand that we may disclose information and documents relating to you, the property, the loan and the conduct of the loan account to any transferee or potential transferee. 14. By signing this application form you will be agreeing that any person interested now or in the future in the loan, the mortgage and other security may rely upon the truth and accuracy of the information contained in this application and any supporting documentation, information or security. 15. REGULATED LIFETIME MORTGAGE CONTRACTS The Financial Conduct Authority (FCA) regulates all new Lifetime Mortgage contracts entered into in the UK except those where less than 40% of the land used as security is used as or in connection with a residential dwelling. Before entering into a new mortgage contract with us we will tell you whether it is an FCA Regulated Mortgage Contract. Applications via mortgage intermediaries Where you have asked an intermediary for advice and a recommendation about a Lifetime Mortgage product the intermediary is responsible to you for any advice they give or any recommendation they make. You should notify the intermediary of any material changes that may be made to the application in order that they can provide you with a revised Illustration. Applications made direct to NRAM plc We are bound by the FCA s Mortgages and Home Finance Conduct of Business (MCOB) Rules. 16. CONTACTING YOU DURING UNSOCIAL HOURS rmally we would only wish to contact you between 9am and 9pm, Monday to Saturday. Occasionally, we may want to contact you outside of these times. Please tick this box if you do not want us to contact you outside of the times stated above. 17. You declare that the statements and particulars given in this application are, to the best of your knowledge and belief, true and complete. 18. If there are any other material facts that could reasonably be construed as likely to influence our decision about this loan application, but have not been revealed as a result of answering specific questions within this application form, you must tick this box and provide details in Section 10. 19. BEFORE YOU SIGN Please check your answers in each section to ensure you have provided all the information required. The checklist at the bottom of this page will help you. First applicant Second applicant Signature Signature CHECKLIST An incomplete form may delay the processing of your application. To help us process your application quickly please check: Have you (both) signed and dated the Declaration section? Have you (both) enclosed proof of your of Birth with your application? This can be a photocopy of the following: Birth Certificate, Passport, Medical Card or Driving Licence. We do not require sight of the originals. Have you enclosed your valuation/application fee cheque (if applicable)? Do not send cash payments through the post. Please do not enclose copies of any Illustrations issued to you. You must retain these for future reference. Please return this form using the Freepost address below. Freepost RTAE CJUZ-KZGK NRAM Mortgage Operations PO Box 625 DURHAM DH1 9JJ NRAM plc. Registered office: Croft Road, Crossflatts, Bingley, West Yorkshire, BD16 2UA. Registered in England and Wales (Company. 3273685). Authorised and regulated by the Financial Conduct Authority. Reg.. 106081. NRAM plc is part of the UK Asset Resolution Limited group. 12