home loans
Secured Loan
Application Form
v2.1 May18
Norton Home Loans Ltd.
Norton House, Manseld Road, Rotherham,
South Yorkshire S60 2DR
Telephone: 01709 512513 Fax: 01709 321639
Secured Loan Application Form
To be completed by the Intermediary/
Client’s name
Intermediary/Packager details
Post code
Contact name
Tel number
Fax number
FCA number
Loan Purpose
I have charged the Applicant(s) fees for arranging this loan:
Advisor Declaration
ion, I have read and agree to the terms & conditions of
the Intermediary Agreement.
I confirm that I have verified the identity of the applicant(s) named in Part 1 of this
form. I have included documents as acceptable to verify identity and address.
I have also discussed the loan payments with the applicant(s) and confirm that
the income and expenditure information is accurate, based upon the information provided by the customer.
I understand that an Offer of Loan cannot be issued without this completed section.
It is an offence to knowingly give false, inaccurate or misleading information when applying for a loan.
If you give such information you may face criminal prosecution and/or civil action for recovery of any
losses incurred by us.
Company name
Network name
(if applicable)
Tel number
FCA number
Total fees
added to
the loan
Total fees
Page 2
Page 3
Section 1 - Personal Details (if more than two applicants please complete a separate form)
Time at Current Address
Previous address if less than 3 years
Applicant 1
Applicant 2
Section 2 - Employment details
Applicant 1 Applicant 2
Employer’s Name or Company Name
Employer’s Address or Company
Telephone Number
How long have you worked here or
been Self Employed?
Income per Annum or Net Profit
p/annum after tax/year end
Details of Additional Income
Source of Income
Source of Income
You must provide evidence of income
ie. payslips or P60
Number of Dependants + Age/s
Name, Address & Telephone Number
of your Accountant if self employed
Employed Self Employed Employed Self Employed
Previous/Other names
Date of Birth (dd/mm/yy)
Do you have rights to reside?
Home Telephone Number
Mobile Telephone Number
Current Address and Post Code
Email Address
£ £
What is your anticipated
retirement age (if applicable)?
If this is before the end of the loan
term please provide evidence of
pension arrangements or how the
mortgage will be repaid in
retirement in the box.
Marital Status (eg married, single,
divorced, separated)
Section 3 - Income/Expenditure details
Monthly Income (net - after tax deduction)
Applicant 1 Applicant 2
£ £
£ £
£ £
£ £
£ £
£ £
£ £
£ £
£ £
Basic Salary
Guaranteed overtime
Private Pension
State Pension
Child Benefit
Working Family Tax & Child Tax Credits
Child Maintenance
Other Benefits
Other Income (please specify details in
Total Monthly Income (Net)
(A) (B)
Monthly Expenditure
Basic Essential Expenditure
Council Tax
Buildings/Content Insurance
Water Rates
Ground Rent/Service Charges
Gas and Electricity
Food and Household Expenditure
Household Goods and Services
Car Expenses (Fuel, Tax, Insurance, Servicing)
Other Travel Costs
Basic Quality of Living Expenditure
TV Licence/Media Package
Endowment/Life Policy/Pension contributions
Clothing and Footwear
Medical Insurance/Costs
Personal Expenditure/Recreation/Social Expenditure
Child Related Expenses (Nursery Fees, Childminding,
Other Expenditure
(incl. cigarettes/alcohol)
School Meals etc)
Commited Expenditure
Total Monthly Expenditure (C)
minus Total Monthly Expenditure (C)
Total Net Monthly Income (A+B)
Disposable Monthly Income before new Loan payment
Court Fines/CCJs and Defaults
Credit Commitments not being repaid (see Section 4)
Total Monthly Income (A + B)
Section 11)
Page 4
Section 2 - Employment details (continued)
Can you provide evidence of your income (eg Bank Statements, Inland Revenue correspondence or accounts) from your self employed work.
Yes No If yes, please submit the evidence along with this application. If no, please explain why no evidence of income is available.
If Self Employed
Section 3 - Income/Expenditure details (continued)
2. Date existing mortgage loan started Account No.
Section 5 - Existing Mortgage
1. Name of existing mortgage lender
Section 4 - Existing Commitments
Existing Debts/Consolidation
Please list all outstanding unsecured debts ie: Credit Cards, Loans, HP etc. If you intend to repay any of these
debts upon completion of the loan from Norton Home Loans Ltd then please indicate by ticking the
appropriate box. Should you indicate that you are repaying a debt and then not do so you are risking the long
term affordability of this loan.
Credit Type Company
Tick if
Settling on
Tick to confirm
who credit
relates to
App 1 App 2
Are you aware of any future changes either to your income or expenditure (including any loans or commitments
which will become payable during the term of the loan) which may impact on your ability to repay the loan?
Yes No
3. Outstanding balance on the existing mortgage Monthly Instalment
4. Is this mortgage in arrears?
Yes No
5. Current mortgage type: Capital Repayment Interest Only Interest rate
I/we authorise Norton Home Loans to deduct the above amounts indicated from the proceeds of my/our loan
and forward the funds on to the stated companies.
Number of payments missed in the last 12 months
Page 5
If Interest Only please give details of how you intend to repay the mortgage at the end of the term:
Page 6
Section 6 - Credit History
Have you/either of you at any time in the last 2 years had arrears on a mortgage, secured loan or any other form of credit by more than
3 months payments?
Yes No
Have you ever been bankrupt or involved in an
Individual Voluntary Arrangement in the last 6 years?
Please give details
If you have now been discharged, please give date of discharge.................................
Do you currently have any other debt management or voluntary arrangements with your creditors?
(If yes, please give details in Section 4)
Yes No
County Court Judgements (CCJs)
Applicant 1 Applicant 2
Have you had £500 or more CCJs
in the last 3 years?
Yes No Yes No
Are you repaying these from this loan?
Yes No Yes No
If you are leaving any CCJs outstanding please ensure any payments you are making towards them are included in the Monthly
Expenditure box in Section 3
Yes No Yes No
(If necessary, please continue in Section 11)
Explanation for arrears (dates, amounts, reason)
(If necessary, please continue in Section 11)
Explanation for CCJs (dates, amounts, reason)
Section 7 - Details of New Loan
Amount Required (excluding any fees and insurance products)
Type of Loan
Home Improvements
Please give a breakdown of
the home improvements
and your estimated costs:
Debt Consolidation
Please give details
Please give purpose of lending (please tick)
Term of Loan
PayDay Lending
Have you ever used Pay Day lending?
Please give details
Yes No Yes No
(If necessary, please continue in Section 11)
Have you previously consolidated any outstanding
Please give details
Yes No Yes No
(If necessary, please continue in Section 11)
(If necessary, please continue in Section 11)
Section 8 - Details of Property to be Mortgaged
Purchase Price
Estimated Current Value
If Right to Buy how much discount did you receive
Property Type (please tick)
Flat-how many storeys in block
Ex-Local Authority
Other (please give details)
Detached Semi-detached
Others (please give details)
Bedrooms Garages
Living Rooms
Freehold Leasehold
Years remaining on lease
If a House or Bungalow is the property (please tick)
How many? Is the property? (please tick)
If Leasehold, are the service charges & ground rent up to date?
If they are not up to date how much do you owe?
(We will pay these direct from the loan amount)
Name and Address of Freeholder
Is the property a shared ownership or housing association property?
Date of Purchase
Reason for increase in value since purchase
Is the property of standard construction?
If no, give details
Will the property be occupied by any members of your family who are over the age of 17, ie: parents, grandparents, brothers, sisters, children,
grandchildren, or your partner.
Please give details of all occupants at the time of completion
Name Relationship to you Date of Birth
Yes No
owned by you
Yes No
Section 9 - Further Information
Applicant 1
Section A - Voters Roll Information
(please print names) (Complete if appropriate)
do not appear on the Voters Roll at the secured address because...
(use box below)
Applicant 2
do not appear on the Voters Roll at the secured address because...
(use box below)
However I/we can confirm that I/we do reside at the secured property address detailed in section 8 & enclose proof of residencies as
Section B - Non-Residency Information (Complete if appropriate)
Please take this as my/our written confirmation that the following named individuals are no longer resident at the security address
(please print names)
Section C - One and the Same (Complete if appropriate)
I can conrm that I
am one and the same person as:
(print name)
Page 7
Section 10 - Insurance Details
Building Insurance
In all cases buildings insurance must be maintained for the reinstatement value of the property
Name and Address of Insurer (current or planned) Policy Number?
I/we authorise the above company to note Norton Home Loans
Ltd on my buildings insurance policy
Section D - Paying the Proceeds of the Loan Please pay the proceeds of our loan into:
Account No: Sort Code:
**I ENCLOSE A RECENT BANK STATEMENT CONFIRMING THE ABOVE DETAILS** A same day transfer is available subject to a fee.
I/we authorise the fee to be deducted from the loan advance in respect of the same day transfer fee to enable you to transfer the funds
into my/our bank account...
Bank details
Account Name:
Re-instatement value of property
Expiry/Renewal Date?
Section E - Payout Deductions (Complete if appropriate)
I/we authorise Norton Home Loans Ltd to deduct the following amounts from the proceeds of our loan and pay to the companies as indicated:
1. £
2. £
3. £
Section 11 - Additional Details
Please use this section to record any other information relevant to the application
Section 9 - Further Information (continued)
Page 8
Page 9
Declaration of Affordability
I/we conrm that the loan payments which relate to this application are aordable to me/us and I/we have taken into consideration:
1. That interest rates may increase and as a result my/our payments will increase.
2. That the loan payments are aordable when taking into account my/our income and expenditure details provided in Section 3 of the
Application Form, which are a true reection of my/our current circumstances and any foreseeable changes to them.
NHL Ltd reserves the right to request additional information
Declarations by you and use of your personal information
Points to note:
• Please take time to read these declarations carefully and then sign them below.
• You should make sure that all sections of the application form have been fully completed before being signed by you. If any section does not apply, please put “not applicable”.
If the application form is incomplete then this may delay our processing of the loan.
• These declarations are addressed to Norton Home Loans Ltd (NHL Ltd) and also other companies associated with the Norton Group and its successors in title and assignees
(referred to below as “NHL Ltd”).
Declarations by you
1. I am/we are 18 years of age or over
2. I am a/we are British Citizen(s) or if I am a/we are foreign national(s) I/we have a right to reside in the United Kingdom throughout the period of the loan.
3. The information provided in my/our application form is correct to the best of my/our knowledge and belief. I understand that NHL Ltd may make all necessary enquiries to
verify the information I/we have given and I/we authorise them to do so.
4. I/we will let NHL Ltd know if any of the information given in connection with my/our loan application changes before the loan completes, especially in relation to my/our financial
5. I/we authorise NHL Ltd to make enquiries of any person in connection with this application including to my/our employer(s), my/our bankers, any other lender I/we have a
mortgage or loan with and any credit reference agency. I/we authorise such persons to disclose to NHL Ltd any information requested from them.
6. I/we confirm that details about anyone who will be occupying the property immediately on completion of the loan have been disclosed by me/us in this application form.
I will let NHL Ltd know if there is to be any change in the occupants before completion of the loan.
7. I understand that unless I/we get the consent of NHL Ltd
a) the property should only be occupied by me/us and my/our family as my/our main residence.
b) no part of the property shall be used for business purposes and
c) that I am/we are not permitted to grant any tenancy or license of the property.
8. I/we acknowledge that NHL Ltd may withdraw the loan offer at any time up until the loan completes and that no reason may be given for doing so. As soon as
the funds have been released to complete the loan, then I/we will be bound by the terms of the loan offer and legal charges that accompanies it (in Scotland, known
as the Standard Security and in Northern Ireland the Mortgage Deed).
9. I/we will inform NHL Ltd if there are any fees and charges that I have agreed to pay to any intermediary which are not shown on any Mortgage illustration or Loan Offer I/we
10. I/we agree that NHL Ltd may without notice transfer or assign the loan that I/we enter into with you to a third party and that this includes any legal or equitable interest
that NHL Ltd has in the mortgage or the security. I also understand that NHL Ltd may outsource the administration of my/our loan to a third party.
11. If I/we request NHL Ltd to send the loan amount by telegraphic, CHAPS or other electronic transfer, I/we authorise you to deduct the transfer fee from the loan amount.
12. My/our income is sufficient to enable me to afford the loan repayments. I am/we are aware that if interest rates increase then my/our monthly payments will go up. I am/we
are aware that I/we will still have to pay the loan if I/we lose my/our job(s) or if illness prevents me/us from working.
13. Where the loan is an interest only loan, I/we understand that it is my/our responsibility to ensure that I/we have an adequate repayment vehicle or have other
arrangements in place to repay the capital at the end of the term.
IMPORTANT - Use of your Personal Information
14. NHL Ltd will use and process your personal details
a) to process the loan application you have made and to use the information to search with credit reference and fraud prevention agencies referred to below,
b) to assist NHL Ltd to administer the loan and any other products that are being provided to you in connection with your application.
15. NHL Ltd will disclose your personal details to
a) NHL Ltd’s insurers, auditors, solicitors, professional advisors, sub-contractors or any person providing services to NHL Ltd or who are involved in the loan application,
who have agreed to treat your personal information details as confidential.
b) any proposed or actual transferee or assignee of the loan or their professional advisors, any funders of NHL Ltd or their professional advisors or any proposed or
actual third party involved in any matter relating to the administration of your loan with NHL Ltd who have agreed to treat your personal details as confidential.
c) any body having a legal right to your personal information, including the police and any other legal and regulatory authorities and government bodies.
d) any person where such disclosure is necessary to enable NHL Ltd to ensure that your obligations under any agreement or mortgage with NHL Ltd is/are being complied
with and to ensure that any security given in connection with any loan is not at risk.
e) any third party with your consent.
16. NHL Ltd will search the files of credit reference agencies and the Electoral Register. Credit Reference agencies will keep a record of this search, whether or not this application
proceeds so that it may be used by other lenders in assessing applications from you and anyone who lives with you. NHL Ltd may check your Personal Details with fraud
prevention agencies and if you give NHL Ltd false or inaccurate information and NHL Ltd suspect fraud, NHL Ltd may record this. Further information, including our ‘Credit
Reference Agency Information Notice’ can be found at www.nortonhomeloans.co.uk/CRAIN
17. NHL Ltd will disclose personal details to credit reference and fraud prevention agencies. Details of how you conduct your account may be given to these agencies, and
repossession information held on any register may be shared with other lenders and used for credit assessment, debt tracing, fraud detection and default in payment to protect
you from theft/fraud. NHL Ltd will add to these records details of your agreement with NHL Ltd, the payments made under it and any default in payment or failure to keep to
its terms. NHL Ltd and other organisations may search these records to
a) help make decisions about credit and credit related services, for you and those with whom you may be linked financially or other members of your household
b) help make decisions on motor, household, credit, life and other insurance proposals and insurance claims, for you and those with whom you may be linked financially or
other members of your household
c) trace debtors, recover debt, detect or prevent fraud, manage our accounts or insurance policies, and
d) verify your identity to prevent money laundering, unless you furnish NHL Ltd with other satisfactory proof of identity.
18. Your telephone calls may be recorded or monitored for training purposes and for your protection. Any email to and from NHL Ltd may also be monitored for the same reasons.
19. Under the Data Protection Act 1998, you have the right of access to your personal records held by NHL Ltd upon written request and payment of fee and you also have
right to request that inaccurate details be amended, or in certain circumstances, be expunged from NHL Ltd’s records. You also have a right of access to your personal
records held by credit reference agencies and fraud prevention agencies and NHL Ltd will supply their names and addresses upon written request from you.
Only sign if you have completed all sections of this form and you are satised that all the information you have provided is correct
Before signing this form please ensure that you have read the declarations and the section marked “use of your personal information”.
By signing this application you are consenting to our processing and using your personal information for the purposes stated.
Signatures of all applicants
Applicant 1 Date
Applicant 2 Date
Norton Home Loans Ltd.
Norton House
Manseld Road
South Yorkshire S60 2DR
Instruction to your
Bank or Building Society
to pay by Direct Debit
Please ll in the whole form, excluding ocial use box, using a
ball point pen and send to:
Service User Number
Reference Number
This is not part of the instruction to your Bank or Building Society
Instruction to your Bank or Building Society:
Please pay NORTON HOME LOANS LTD. Direct Debits from the account
detailed in this instruction subject to the safeguards assured by the
Direct Debit Guarantee.
I understand that this instruction may remain with NORTON HOME
LOANS LTD. and if so details will be passed electronically to my
Bank/Building Society.
Name(s) of Account Holder(s)
Bank/Building Society Account Number
Bank Sort Code
Name and full postal address of your Bank or Building Society
To: The Manager
Banks and Building Societies may not accept Direct Debit instructions for some types of accounts
This guarantee should be detached and retained by the Payer.
• This Guarantee is oered by all banks and building societies that accept instructions to pay Direct Debits.
• If there are any changes to the amount, date or frequency of your Direct Debit Norton Home Loans Ltd will notify you 10 working days in
advance of your account being debited or as otherwise agreed. If you request Norton Home Loans Ltd to collect a payment, conrmation of
the amount and the date will be given to you at the time of the request.
• If an error is made in the payment of your Direct Debit, by NORTON HOME LOANS LTD. or your bank or building society, you are entitled to
a full and immediate refund of the amount paid from your bank or building society.
- if you receive a refund you are not entitled to, you must pay it back when Norton Home Loans Ltd asks you to.
• You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written conrmation may be required. Please
also notify us.
home loans
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