Intermediary Rate Switch Request Form
Rate switch products can be viewed at: hodgebank.co.uk/intermediaries/product-rates– rate switch requests can only be
requested by registered intermediaries.
Intermediary registration forms can be found at hodgebank.co.uk/intermediaries/registration
If you have any queries regarding registration, Please contact us on 0800 138 9109 or email@example.com
Rate Switch Details
Customer’s current product
(50+/RIO/Retirement Mortgage/Holiday Let)
D D M M Y Y
New product code
Pay upfrontAdd to loan
I can conﬁrm that I have authorisation from the customer(s) to obtain data on their behalf and conﬁrm that advice and
recommendation has been given in respect of the rate switch request.
D D M M Y Y
Intermediary signature Print name
Hodge is a trading name of Julian Hodge Bank Limited which is registered in England and Wales (No. 743437). It is authorised by the Prudential Regulation
Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Its registered ofﬁce is One Central Square, Cardiff, CF10 1FS.
Hodge’s Privacy Notice conﬁrms how we manage and process your company and client’s personal data. If you require more detail on how we handle your information please go to hodgebank.co.uk/privacy or call 0800 289 358
For intermediaries only
For more information speak to our team direct:
0800 138 9109
HM IRSRF 09/20
Name of intermediary
Company name and
FCA reference no.
Your ﬁrm If relevant, your principle/network
For Retirement Mortgage only - I conﬁrm that I have passed an appropriate approved examining board’s specialist examination in
equity release and I have provided/supervised the equity release advice and recommendation.
click to sign
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