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If the applicant(s) have not signed the declaration, I confirm that I have drawn the applicant(s)’ attention to the
matters contained therein.
This Decision in Principle is being submitted on the understanding the applicants are UK residents with the right
to live in the UK permanently. The loan will be secured against the applicant(s) main residence, which meets
property eligibility criteria as published on the Hodge website.
Date
D M YD M Y
Signed Print name
Residential Mortgage Application
for a Decision in Principle
Name of adviser
Company name
FCA reference
number
£
Office address
Email address
Contact telephone
number
Date of advice
Mortgage club
and/or network
Broker fee
(if applicable)
New business DIP Reference
ReferenceAdditional Borrowing
50+ Mortgage RIO Mortgage
With Fee Without Fee
Your firm If relevant, your principle/network
(only available for RIO Mortgage)
(only available for RIO Mortgage)
2yr discount 10yr fixed
2yr fixed Fixed for life
5yr fixed
Please complete this form as accurately as possible as missing information may affect our decision.
Adviser Declaration
This application is for
Product
Fee
Interest rate
D M YD M Y
LTV Option
Retirement Mortgage
(only available for additional borrowing)
70% Max LTV 75% Max LTV50% Max LTV 60% Max LTV
(only available for 5 year fixed rates)
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Previous name(s)
in the last six years
Date of birth
Nationality
What is your marital/
civil partnership status
Telephone/mobile number
Email address
Residential status
Homeowner
Renting Other
Homeowner
Renting Other
Current address
Time at address
Years Months Years Months
Previous address
(if less than three years)
Please provide details of any other
addresses in this period in the
additional information section.
Time at address
Years Months Years Months
Employment status Employed Employed
Self-employed Self-employed
Retired Retired
Number of dependent adults
and children living at the
address
Years
Adults
Children
If there are any non-dependent adults at the property,
please provide details in the additional information section.
Personal Information
Applicant 1 Applicant 2
Title
Surname
Mr Mrs Miss Ms
Other
Mr Mrs Miss Ms
Other
Full forename(s)
D DM MY YD DM MY Y
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Existing Mortgage Details (if applicable)
Your Loan Requirements & Property Details
50+ Mortgage Only (please complete the following)
Current lender
Balance outstanding
Contractual monthly
payment
£
£
Y N
Will this mortgage be
repaid on completion?
If not being redeemed, please
provide further details
Why are you taking
out this mortgage?
House purchase Re-mortgage
Raising new capital
Loan purpose
If for home improvements, please
provide basic details of the works
and estimated costs
Security address
(if different to the current address)
Property details
House
Detached
Bungalow
Semi-detached
Flat/Maisonette
Terrace
Y N
Does the property
meet our criteria?
Our acceptable property criteria are available on our website
Estimated value or
agreed purchase price
Loan amount required
£
£
Product fee
Add to loan
Deduct from advance
Pay on application N/A (fee free)
Loan term
Years
Property details
Cashing in existing investments Downsizing
Cashing in an endowment policy
Sale of other property
If more than one strategy has been selected, please provide details
of the value attaching to each strategy in the additional info section.
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Credit History
Outstanding Unsecured Borrowing
Applicant 1 Applicant 2
If the answer is “yes” to any of the questions below, please provide details in the additional information section.
Y N
Had any CCJs or defaults
in the last six years?
Has each applicant:
Y N
Y N
Entered into an IVA or debt
management programme
in the last six years?
Y N
Y N
Had any mortgage arrears
or arrears on secured or
unsecured borrowing in
the last three years?
Y N
Y N
Been declared bankrupt
within the last six years?
Y N
Y N
Ever been repossessed?
Y N
(e.g. personal loans, hire purchase, mail order, credit cards or overdrafts)
Applicant
Loan
type
Balance
outstanding
Monthly
payment
To be repaid
on completion
Y N
App 1 App 2
££
Y N
App 1 App 2
££
Y N
App 1 App 2
££
Y N
App 1 App 2
££
Y N
App 1 App 2
££
Y N
App 1 App 2
££
If the applicant(s) have any other mortgages or own any more properties, please complete the additional property
form which is available on our website.
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Employment & Self-employment Income
Outgoings
Monthly Outgoings
Basic essential outgoings (utilities, council tax, food essential
travel etc.)
Basic living outgoings (clothing, TV, internet, socialising etc.)
Discretionary expenditure (holidays, non-essential travel etc.)
Ongoing contributions into an investment which is a
nominated repayment vehicle for this loan
Other committed outgoings (excluding credit commitments
set out above – please specify)
£
£
£
£
£
Applicant 1 Applicant 2
Occupation
Years in job
Age you intend to
stop working
If you are employed:
Gross annual salary
£ £
Shift allowance (annualised)
£ £
Regular annual bonus
or commission
£ £
Car allowance/large
town allowance
£ £
If you are self-employed:
Sole traders: 2 years net
profit
20
Partnerships: 2 years drawings
Companies: 2 years salary
and dividends
20
20
£
£
£
20
20
20
£
£
£
Year Year
If the applicant income has reduced in the latest year or reflects a reducing trend, please provide details in the
additional information section.
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Pension Income in Payment
Pension Savings & Investments
Applicant 1 Applicant 2
You should only include pensions that are already in payment in this section. If any pensions declared are subject to
any changes or claims such as a pension sharing order, please provide details in the additional property section.
Annual amount Annual amount
Total state pension
entitlement
£ £
State benefits payable for life
£ £
Defined contribution
pensions & annuities
(We will assume no indexation and no spouse
benefit. If different, please provide details in
the additional information section)
£ £
Defined benefit pensions
(We will assume indexation and 50% spouse
benefit for joint applications. If different,
please provide details in the additional
information section)
£ £
Applicant 1 Applicant 2
In this section, you should include pensions and investments which will be used to generate retirement income in
the future. We will assume that all of these assets (with the exception of the state pension) shall be inherited in full
by a surviving spouse. If different, please provide details in the additional information section.
Age you intend taking an
income from these funds
Annual amount Annual amount
Projected state pension
Full entitlement Full entitlement
Yes No Yes No
£
Collective investments
(e.g. investment trusts, unit trusts, OEICs)
£
If no
Annual amount Annual amount
Invested defined benefit
pensions
£ £
Fund value Fund value
Defined contribution pension
savings & drawdown plans
£ £
Fund value Fund value
£ £
Value Value
Cash savings
£ £
If no
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Rental Income
Additional Information (Should you require more space, please continue on separate sheets of paper)
Applicant 1 Applicant 2
You should include the net rental income earned by each applicant in this section. We will assume that this income shall
continue for the entire term of the mortgage. If different, please provide additional details in the additional information section.
Annual amount Annual amount
Rental income
£ £
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Declaration
I understand, confirm and agree the following:
Use of your Personal Data
The personal details you give on this form will be
subject to the provisions of the General Data
Protection Regulations 2018.
The information will be retained only for as long as
necessary in accordance with our Retention Policy
by Hodge who is the data controller, and may be
stored on paper or an electronic format.
The information held about you may be used for the
following purposes:
Administering your application
Verifying your identity and anti-money
laundering checks
Assist in fraud prevention
Reporting to regulators and authorities
Market and product analysis.
The information held about you may be shared with
the following parties:
Hodge’s approved service providers in relation
to this application; Other members of Hodge’s
group, its subsidiaries and associated companies
Regulators or authorities where required or
permitted by law.
You have the right to request access to your personal
information held by Hodge; to do so, this request must
be made in writing using our Subject Access Request
Process. Further information regarding this can be
found on our website.
Telephone calls may be monitored and/or recorded in
the interest of security and to help improve our service.
Hodge may also use your information to contact you
about its products and services that it believes may be
of interest to you.
Occasionally, we may have products and services that
could be suitable for you. We would like your permission
to contact you by phone, post, SMS or email.
Please confirm if you would like to hear from us about
these services:
We will always treat your personal details with the
utmost care and will never pass or sell your information
to other companies for marketing purposes.
Your rights as a data subject
At any point while we are in possession of or processing
your personal data, you have the following rights:
Right of access – you have the right to request
a copy of the information that we hold about you
as mentioned above
Right of rectification – you have a right to correct
data that we hold about you that is inaccurate or
incomplete
Right to be forgotten – in certain circumstances you
can ask for the data we hold about you to be erased
from our records
Right to restriction of processing – where certain
conditions apply you have a right to restrict the
processing
Right of portability – in certain circumstances,
you have the right to have the data we hold about
you transferred to another organisation
Right to object – you have the right to object to
certain types of processing such as direct marketing
Right to object to automated processing, including
profiling – protection against targeted marketing
and decision making
Right to judicial review - in the event that We refuse
your request under rights of access, we will provide
you with a reason as to why. You have the right to
complain as per the subject access request process
All of the above requests will be forwarded on should
there be a third party involved in the processing of
your personal data, i.e. if a data subject was to raise
a Subject Access Request.
Applicant 1
By Phone
By Mail
By Email
By SMS
Applicant 2
By Phone
By Mail
By Email
By SMS
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Declaration
Credit searches and fraud prevention
Hodge will search credit reference and fraud
prevention agencies to check your identity,
credit status and help us to make decisions
Hodge will undertake a credit search against
each applicant recorded on this form
Information on applications will be sent to credit
reference agencies and will be recorded by them
The credit reference agency will check the
details supplied against third party databases,
public or otherwise
A record of the search will be retained
The credit reference agency may use the details
provided to assist other companies for verification
and identification purposes
If we decline this application, we are not obliged
to tell you the reasons behind our decision
If you borrow from us, we will give details of your
accounts and how you manage it/them to credit
reference agencies. If you borrow and do not
repay in full and on time, credit reference agencies
will record the outstanding debt. This information
may be supplied to other organisations by credit
reference agencies and fraud prevention agencies
to perform similar checks and to trace your
whereabouts and recover debts that you owe.
Records remain on file for six years after they
are closed, whether settled by you or defaulted
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
Full details of what we do and how we, credit reference
and fraud prevention agencies will use
your information are published on our website.
Alternatively, a copy can be sent to you on request.
Please phone us on 0800 731 4076.
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mortgages@hodge.co.uk
0800 721 4076
Customers: hodgebank.co.uk
Advisers: hodgebank.co.uk/intermediaries
Hodge is a trading name of Julian Hodge Bank Limited which is authorised by the Prudential Regulation Authority and regulated
by the Financial Conduct Authority and the Prudential Regulation Authority under registration number 204439. Registered office
in England & Wales is One Central Square, Cardiff, CF10 1FS (No.743437). Hodge’s Privacy Notice confirms how we manage and
process your 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.
Declaration
Signed
Print name
D DD DM MM MY YY Y
Date
Signed
Print name
Date
Applicant 1 Applicant 2
Customer Declaration
I agree to the Terms and Conditions of the account
I have read and understood the Use of Your Personal Data declaration and consent to the use of my information
for the purposes stated
I declare that the information that I have provided is correct to the best of my knowledge and belief
I confirm that I wish to proceed on the terms set out in the Decision in Principle
Where relevant, I enclose payment in order for a chartered surveyor to value my property. This is not a survey
I understand that this fee is not refundable, even if the property is not eligible for this mortgage. Payment of this
fee does not mean that Hodge is obliged to accept my application
I understand that this mortgage will be subject to the 50+ Mortgage Terms and Conditions (These will be provided to
you with any offer we issue but in the meantime, they can also be downloaded from our website and are available on
request)
I have the right to withdraw from this mortgage application at any time before it is complete and I have received
the monies. However, if I withdraw, I will not receive a refund of any fees I have paid to Hodge and I may still be
required to pay my financial adviser and solicitor for the work they have undertaken on my behalf
All the details in my Decision in Principle and this application are, to the best of my knowledge and belief,
true and complete. If Hodge finds any to be untrue, it could affect my eligibility for the mortgage or reduce
the amount I may borrow.