Application Packaging Checklist
Decision in Principle carried out?
DIP Ref Number if applicable:
Yes No
All forms/reference templates can be downloaded via:
Version 3. June 2019
Broker Name:
Broker Company:
Packager Company:
The minimum requirements for all cases where LTV is 80% or less
Fully completed Application Form
Fully completed Direct Debit Mandate
Two forms of ID for each applicant. (Refer to Section 8 of criteria)
P60 and last 3 months payslips for each applicant. If paid weekly, last full months wage slips and P60.
Last three years Company Accounts for Self Employed/last 3 SA302’s.
Last three consecutive months personal bank statement for each applicant, showing salary credit.
Proof of rental payment covering 12 months where applicable
Proof of mortgage payments, covering 12 months, where applicable
Proof of deposit/gifted deposit letters
Valuation fee (including £125 application fee) Refer to Section 20.3 of criteria
Three Years Proof of Residency (if not on Voters Roll)
Fully Completed Budget Planner
Fully Completed Fee Declaration Form
Where the LTV exceeds 80%, all of the above are required, however, the following variations apply
P60 and Last three consecutive months payslips plus Employment reference
Ad-hoc packaging requirements
Interest Only Dec form & proof of repayment strategy – cases with any element of Interest Only
Completed Personal Assets and Liabilities Statement – if applicant has any other properties
Let to Buy – Consent to Let from existing Lender
Completed Loan into Retirement Declaration form -
If yes then 10 years remaining proof on retirement income is required
Memorandum of Sale from Housing Association for all Shared Ownership cases
Right to Buy Notice from Council for all Right to Buy cases
Please Note: An application must contain the minimum packaging items before the assessment process can begin.
Those not containing minimum requirements may be returned.
Title Title
First name(s)
Any previous name(s)
National Insurance Number
Date of birth (dd/mm/yy)
Marital Status:
Please state the number and age
of any financial dependants
Please state the number
and age of any financial
Smoker Yes No
Yes No
Yes No
Yes No
Yes No
Yes No Yes No
Yes No Yes No
Owner *Tenant *Living with others Owner *Tenant *Living with others
Smoker Yes No
Surname Surname
Personal Details First Applicant Second Applicant
Married or Civil Partnership/Single/Divorced/Widowed
Separated/Co-Habiting (delete as appropriate)
If Ye s to any of the above, please supply full details of the Additional Information page.
If Ye s to any of the above, please supply full details of the Additional Information page.
Current address:
(If less than 3 years, please give
all addresses during this period
and length of time at each
address on the Additional
Information page). For ex pat
applications, please provide your
last known UK address on the
Additional Information page.
How long have you lived here?
Are you a first time buyer?
Residential Status
Telephone number (inc. code)
Email address
Have you applied to any other lender for a mortgage within the
last 6 months?
*(please give details i.e. relationship/landlords details on the Additional Information page)
Married or Civil Partnership/Single/Divorced/Widowed
Separated/Co-Habiting (delete as appropriate)
Present Housing First Applicant Second Applicant
Post Code Post Code
Years Months Years Months
Yes No
Yes No
Mortgage Application Form
Please answer fully all questions on this form
All correspondence will be sent to the address of the first applicant as this person will be entitled to voting rights in respect of the proposed mortgage.
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Version 3. June 2019
Are you an existing customer of the Society?
Existing Account Number:
Have you ever been declared bankrupt or insolvent
or is there any such action pending?
Have you ever entered into any arrangements with your creditors
or are you party to a voluntary arrangement?
Have you had a court order/decree made against you for debt or
is there any such action pending?
Have you ever had a default registered against you?
Have you ever had a property repossessed?
Have you ever been in arrears with your mortgage/rent/credit
card payments?
Have you or any person who will reside in the property to be
mortgaged, received a formal police caution in the last 5 years, ever
been convicted of, or have any prosecution pending for any offence
other than for parking or speeding, excluding any which are spent under
the Rehabilitation of Offenders Act 1974? If Yes, please provide details
on the Additional Information page.
What is your occupation?
If you are a sole trader, a partner in a firm or a company director with a 20% or
more shareholding, please tick the box and complete the self-employed section.
What is your annual gross basic income? £
State any other income eg. bonus, overtime, benefits etc. £
PLEASE NOTE: You will need to provide the originals of your last 3 months’ bank statements, your last 3 months’ consecutive payslips and your last P60.
Current Employer
(If self-employed please detail
your trading name and address)
How long have you been with your current employer/trading?
(If less than 3 years, please provide previous employment history
to cover last 3 years on Additional Information page).
Is your current employment permanent?
*If No, give details on the Additional Information page
Do you make any maintenance/child support payments to court
or on a voluntary basis?
If yes, how much per month?
PLEASE NOTE: You will also need to provide your last 3 years’ accounts for all self-employed earnings.
Name and address of your
accountant (if applicable)
Occupation, Income & Expenditure First Applicant Second Applicant
Name of Company
Yes No
Tel: Fax:
Yes No
Tel: Fax:
Name of Company
Yes No
Tel: Fax:
Yes No
Tel: Fax:
Version 3. June 2019
Do you have a mortgage or secured loan or any other loans outstanding?
eg. Bank/Car Loan, Hire Purchase, Credit Cards, Student Loan, Child Minding costs.
If Yes , enter details below and indicate if the loan will be repaid on or before completion of your mortgage.
If further space is required please detail on the Additional Information page.
Is the current property to be sold before you take out
this mortgage. If No please explain how the property
will be used in the Additional Information page.
Current Commitments First Applicant
Yes No
Yes No
(eg. Dudley Building Society)
Type of Loan
(eg. Secured, Personal)
To be
Account Number
Yes No
If YES, what will be the anticipated sale price
Second Applicant
Buy To Let Portfolio
Please give details of any buy to let mortgages that will remain upon completion of this mortgage.
Total Number of Properties
Estimated Value of Portfolio
Balance Outstanding
Monthly Mortgage Payment Total Monthly Rental Income
£ £ £ £
Version 3. June 2019
Is the property?
If the property is of non-standard construction, please provide details on the Additional Information page.
Mid Terrace
End Terrace
Storeys in Block
Purpose Built
Central Heating
Approx Floor Area
No. of Bedrooms
No. of Rec. Rooms
Year Built
Name of Vendor
Who should the valuer contact to gain access to property? Name Daytime tel no. (inc. code)
Will you use the property solely for residential purposes? If No, answer the following questions on the Additional Information page.
1. Which rooms will you reside in? 2. What will the other rooms be used for?
3. What commercial use if any will be made of the property? 4. What will the grounds be used for?
Is vacant possession of the property being obtained on completion of the purchase and/or mortgage?
Do you intend to occupy the property immediately on completion?
Will any portion be sub-let? If YES, please give details on the Additional Information page.
Is this a purchase or remortgage?
Do you intend to let the property to a family member now or at any time in the future, or to live in the property yourself
at any time in the future?
Do you own any other BTL properties?
If the property was inherited, or purchased, has the property ever been occupied by you or a related person?
Is the property leasehold? If leasehold, what is the unexpired term?
Name and Address of Landlord
Will you be providing from your own savings all of the monies required in addition to this loan to enable you to purchase the property?
If No, please give details on the Additional Information page.
Will any additional borrowing be secured against the property by a second charge?
If Yes, please give details on the Additional Information page.
Name and address of Estate
Agent selling the property
Yes No
Yes No
Yes No
Yes No
Purchase Remortgage
Yes No
Yes No
Yes No
Yes No
Yes No
Your Home and Mortgage Needs
£ £ Yrs
Address of the property to be mortgaged
At what age do you plan to retire? FIRST APPLICANT SECOND APPLICANT
If the chosen mortgage term takes you over your intended retirement age please confirm how you intend to continue to meet the repayments after retirement
by completing our Loan into Retirement Declaration Form.
Which type of valuation report do you require?
Should a Building Survey be required kindly contact Dudley Building Society. The appropriate fee will be quoted on request.
*See “A Guide to Valuation Fees” leaflet for details.
Mortgage Product
*Report and Valuation for
Mortgage Assessment
*Homebuyers Report *Building Survey
We can arrange quotations for General Insurance products. Please select one box from each section. We will contact you if a selection has not been made.
Your property must be adequately insured whilst in mortgage to the Society. We can arrange this cover with Paymentshield.
Insurance is also available to cover the Contents in your home. You may also wish to insure your possessions and valuables away from your home, including
money and credit cards, sports equipment, cycles, etc.
The Society offers a competitive householders insurance policy to provide the cover you need. If you would like details and a premium quotation, entirely without
obligation, please tick the “Yes” box below and we will contact you.
Please tick one of the following boxes:
YES Please contact me/us regarding Building and Contents insurances, entirely without obligation.
NO I/We wish to arrange my/our own Buildings and Contents insurances.
N.B. An administration fee is payable if you elect to arrange your own Buildings insurance.
LEASEHOLD The Buildings insurance will be arranged by the lessor as a condition of the property lease.
Buildings & Contents Insurance
Mortgage Protection
We can arrange for an Openwork Limited Representative to discuss your protection needs, such as;
• Life Cover
• Critical Illness Cover
• Mortgage Payment Protection Insurance
If you would like to arrange an appointment please tick the following box
Solicitor Details
NOTE: LMS will appoint a solicitor to act on our behalf in this transaction. You can also use this solicitor. However, if you decide to use your own solicitor on a Separate
Representation basis you will be liable for two sets of legal fees.
Post Code
Name and address of Firm Name of person acting
Tel No. (inc. Code)
Fax/DX No. (if known)
Yes No
Other Occupiers Age 17 or Over
Title Surname First Names Relationship Date of Birth
Will there be any persons who will reside in the property on completion of the mortgage other than the applicants?
If Yes, please enter details below.
Method of Payment - How Will You Repay Your Loan?
£ £
Total Loan Amount
Direct Debit
Interest Only
To be repaid as:
Yes NoIs the basis for paying this loan in currancy other than GBP?
If yes which currency?
Please be aware YOU MUST have suitable arrangements in place to repay any part of the loan not on a repayment basis.
If all or part of the loan is to be paid on an interest only basis, please confirm how you intend to repay the capital element of the mortgage on the
Additional Information page.
Version 3. June 2019
Version 3. June 2019
Your Personal Information and What We Do With It
Marketing Preferences
We would love to keep you informed about the products and services that are available to you as a member of Dudley Building Society. In order to receive them please confirm
your preferences by selecting the following:
Applicant 1 Applicant 2
Email Post Telephone Email Post Telephone
Our Society takes its responsibilities for data management very seriously
and we have thoroughly detailed our approach to how we collect and use
information on the ‘Privacy’ page on our website. This explains how we collect
and manage personal information and what we do with it. Please visit www. for more information, alternatively you can
request an electronic or paper copy of our privacy statements by:
Telephone: 01384 231414
Post: Dudley Building Society, 7 Harbour Buildings, The Waterfront,
Brierley Hill, West Midlands, DY5 1LN
We can be contacted at any time if you have queries about this privacy notice or wish
to exercise any of the rights mentioned in it by writing to us at The Secretary, Dudley
Building Society, 7 Harbour Buildings, The Waterfront, Brierley Hill, DY5 1LN.
This privacy notice may be updated from time to time. You should check regularly so that you can read the
up to date version.
How do we share your information with Credit Reference Agencies?
In order to process your application, we will perform credit and identity checks on you
with one or more credit reference agencies (“CRAs”). To do this, we will supply your
personal information to CRAs and they will give us information about you. This will
include information from your credit application and about your financial situation
and financial history. CRAs will supply to us both public (including the electoral
register) and shared credit, financial situation and financial history information and
fraud prevention information.
We will use this information to:
Assess your creditworthiness and whether you can afford to take the product;
Verify the accuracy of the data you have provided to us;
Prevent criminal activity, fraud and money laundering;
Manage your account(s);
Trace and recover debts; and
Ensure any offers provided to you are appropriate to your circumstances.
We will continue to exchange information about you with CRAs while you have a
relationship with us. We will also inform the CRAs about your settled accounts. If you
borrow and do not repay in full and on time, CRAs will record the outstanding debt.
This information may be supplied to other organisations by CRAs.
When CRAs receive a search from us they will place a search footprint on your credit
file that may be seen by other lenders.
If you are making a joint application, or tell us that you have a spouse or financial
associate, we will link your records together, so you should make sure you discuss this
with them, and share with them this information, before lodging the application. CRAs
will also link your records together and these links will remain on your and their files
until such time as you or your partner successfully files for a disassociation with the
CRAs to break that link.
How do we share your information with Fraud Prevention Agencies?
The personal information we have collected from you will be shared with fraud
prevention agencies who will use it to prevent fraud and money-laundering and to
verify your identity. If fraud is detected, you could be refused certain services, finance
or employment. Further details of how your information will be used by us and these
fraud prevention agencies, and your data protection rights, can be found by writing to
us using the details above.
What should you do if your personal information changes?
You should tell us without delay so that we can update our records.
The contact details for this purpose are:
Telephone: 01384 231414
Post: Dudley Building Society, 7 Harbour Buildings, The Waterfront,
Brierley Hill, West Midlands, DY5 1LN
There are a number of fees that are incurred when submitting your mortgage application. Some of these fees are payable in advance. For fees that are not payable in
advance, you have the option of paying these fees before your mortgage funds are released, or adding them to the amount you wish to borrow. Any fees you choose
to add to the mortgage will incur interest.
Please indicate below how you would like to pay each of the fees applicable to your mortgage application. Fees are explained in the European Standardised
Information Sheet which has been provided by your advisor.
Please tick your choice for any applicable fees:
Application Fee Payable in advance only
Valuation Fee / Homebuyers Fee Payable in advance only
Arrangement Fee (if applicable) Pay in advance Add to Loan Not Applicable
CHAPS Fee Pay in advance Add to Loan
Sealing Fee Payable on Redemption only
This is our standard mortgage application upon which we intend to rely. For your
own benefit and protection you should read these terms carefully before signing
them. If at any point this declaration is unclear please ask for further information.
I/We apply for a mortgage loan.
If I am an individual I apply to be a Borrowing Member according to the Rules of the
Society, copies of which are available from the Society’s Principal Office or any branch.
If this is a joint application by individuals I/we understand that the First Applicant will
be the person named first in the Society’s records in respect of the mortgage and will
be the Representative Joint Borrower according to the Rules (provided that individual is
a Borrowing Member).
I understand that if I am a Body Corporate or apply as a bare trustee for a Body
Corporate, that a Body Corporate cannot be a Borrowing Member of the Society and
that no person will exercise voting rights in respect of the mortgage under the Rules.
I/WE declare that:
1. I/We have been given a copy of the European Standardised Information Sheet. I/
We have read the contents of this document and having had time to consider
this, I/we wish to proceed with the mortgage application.
2. I/We are over 18 years of age.
3. The information given in this application is true to the best of my/our knowledge
and believe that I/we have disclosed any additional information which is material
to my/our application. I/We understand that Dudley Building Society will rely on
the information provided in considering my/our application. If, prior to completion
of the mortgage, there is any change in my/our circumstances which affects (or
may affect) the information supplied, I/we will notify Dudley Building Society in
writing immediately. I/We understand that Dudley Building Society may withdraw
or vary the terms of any mortgage offer at any time prior to completion.
4. I/We understand that if mortgage offer is made, Dudley Building Society will
instruct a Solicitor/Licensed Conveyancer to act on its behalf and that I/we will
be responsible for the Society’s legal costs and disbursements whether or not the
mortgage is completed.
5. I/We authorise Dudley Building Society or its agents to instruct a Valuer to
prepare a mortgage valuation report at my/our cost and I/we understand that the
fee is payable in advance and is not returnable whether or not an offer of a loan
is given. I/We understand that such a report will be obtained by Dudley Building
Society for its own purposes and that Dudley Building Society is not the agent of
the valuer or firm of valuers. I/We further understand that neither Dudley Building
Society nor the valuer nor the firm of valuers will warrant, represent or give any
assurance to me/us that the statements, conclusions and opinions expressed or
implied in the report and mortgage valuation are accurate or valid and that the
report will be supplied without any acceptance of responsibility on their part to
me/us. I/We accept that I/we will be given a copy of this report. For re-mortgages
of up to 60% loan to value the Society may use a limited external inspection or
computer based data to value the property. In such cases I/we will not receive a
copy of the report.
6. I/We have received and read the following information:
a) Guide to Valuation Fees;
b) List of Charges.
7. I/We confirm that my/our income is as stated in the application and is sufficient
to support all of the relevant payments required to sustain the mortgage.
I/We understand that a false or misleading declaration may forfeit any mortgage
offer or subsequent contract and that a failure to maintain the payments due
may result in repossession and subsequent sale of the property by Dudley
Building Society.
8. I/We authorise the Society or its agents to make any enquiries of such persons
it considers necessary in relation to this application, to confirm the truth and
accuracy of the information. Any costs incurred in doing so will be my/our
responsibility. I/We authorise Dudley Building Society to disclose any information
provided by me/us on this application to a collective mortgage or other credit
data checking system so that it can be made available to other financial
institutions where this is done in the interest of fraud prevention.
9. I/We authorise Dudley Building Society or its agents to disclose details in this
application to one or more credit reference agencies and to use appropriate
statistical techniques (credit scoring) as part of the decision making process
when assessing my/our application for credit. [Whether or not the mortgage
is granted a record of the search will be recorded against my/our file by the
agencies concerned. This information may be searched by credit grantors and
used in assessing applications for future banking, loan or hire facilities and for
debt collection purposes as to how the I/we have performed in meeting my/
our obligations under the mortgage. If the mortgage is granted, it may pass
information relating to the conduct of the account in accordance with the data
protection registration held by Dudley Building Society. (The names of such credit
reference agencies can be supplied by Dudley Building Society)].
10. In the event of this application or any mortgage offer which may be made not
proceeding, I/we will not be entitled to a refund of fees or related costs.
11. No structural alterations shall be made without the prior written consent of
the Society.
12. Interest on my mortgage will be calculated from the date of advance on a
monthly basis.
13. I/We agree to be bound by the Rules of the Society and the terms of the
mortgage deed.
14. I/We understand that Dudley Building Society may withdraw or vary the terms of
any conditional mortgage offer at any time prior to completion.
15. I/We understand that Dudley Building Society may withdraw any binding
mortgage offer if a material change develops in which the condition, value or title
of the property is affected or my/our ability to afford the loan is affected.
16. I/We being the named applicant(s) agree to my/our customer record(s) being
amended to reflect my/our new address on completion of this mortgage, and I/
we acknowledge that other family records will not be automatically updated
unless I/we confirm this in writing.
17. I/we understand that, where it is necessary, my/our data may be shared with, or
access provided to, third parties involved in dealing with my/our application. Such
third parties may include (but is not limited to) third party processors and/or
professional advisers.
The Lender is Dudley Building Society.
By signing this application you are:
a) Confirming that you have read and understood the sections entitled ‘Your
personal information and what we do with it’’ and the Society’s Privacy Notice
b) Giving your consent to the uses and disclosures of information listed.
c) Making the declaration and giving the authorities set out in the ‘mortgage
application declaration’ above.
d) Authorise Dudley Building Society to obtain any information they may require.
e) Confirming my/our preferences in regard to marketing from
Dudley Building Society.
Signed (First Applicant) Signed (Second Applicant)
Date: Date:
Version 3. June 2019
Additional Information
Version 3. June 2019
Identification and Address Verification
To help protect against fraud we are required by law to check all new customers names and addresses. This section need not be completed where the applicant is an existing
customer of the Society, but an existing account number MUST be entered in the Personal Details Section.
DIRECT/POSTAL APPLICATION - Please ensure the customer has supplied the original (or ‘approved’ photocopy) for Section A.
Electronic verification by DBS will also be required
INTRODUCERS - Identity should be verified as for Direct Applications or FCA ‘introductory’ form completed. Electronic verification by DBS will also be required.
Reference Number
Reference Number
Reference Number
Reference Number
Issuing Office/Company
Issuing Office/Company
Issuing Office/Company
Issuing Office/Company
Government Document
Passport/Driving Licence/Benefit Book
Electronic Verification
FCA Introductory Form
Name of Introducer
Signature of Introducer
Level of Service Given
FCA Reference Number
Charges made by
FCA Lending Practice - Mortgage Intermediaries Only
Documentation Checklist - Mortgage Intermediaries Only
Branch Authorisation
I declare that I have provided advice and relevant product information to the customer(s) and will confirm in writing, where appropriate, why the mortgage product
is suitable. I confirm also that where an introductory fee will be received that this has been disclosed. Please note that the Society will only accept applications from
Intermediaries who are currently registered with the Financial Conduct Authority (FCA). To enable us to check this position, please enter your FCA reference number below.
Please use this checklist to ensure you have enclosed the following, before submitting, tick (3) if enclosed. THIS IS ESSENTIAL TO ENSURE YOUR APPLICATION
Please provide items 1-5 for all applicants whose income is being used to support the mortgage application.
Latest 3 months’ bank statements.
These must show a full 3 month history of
mortgage payments and salary credits
Last annual mortgage statement
Latest P60
Latest 3 month’s consecutive pay slips
Last 3 years’ accounts (self employed only)
Valuation fee £
Where required these MUST be enclosed
Administration fee £
Valuation fee £
Identification for postal cases
Official Mail if not on voters roll
In ALL cases can you please remember:
• to complete identification and address
verification and enter in section above;
• to ensure highlighted signature boxes
are completed;
• Direct Debit form is always fully completed
Principal Office:
Dudley Building Society, 7 Harbour Buildings, The Waterfront, Brierley Hill DY5 1LN
Tel: 01384 231 414 | Fax: 01384 233250
email: | | twitter: @DudleyBS
The Society is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.
Version 3. June 2019