Title

Forename*

E-mail address*

Home Telephone*

Work Telephone

Mobile Telephone

Best Time to Call

House Name/Number*

Street *

Town*

County*

Postcode*

Property type

Number of Bedrooms

1. Do you want to live in the property after the sale

yes

no

6. Do you have a mortgage on it?

yes

no

2. Why are you selling the property?

7. Mortgage amount outstanding?

3. How long have you owned the property?
0-1 years 1-5 years 10-15 years 15-20 years 20-25 years 25 years+

8. Do you have arrears on your mortgage?

yes

no

4. What is the current value?

9. Please type any additional information
in the box below (i.e. secured/unsecured loans)

5. How old is your property?