HSBC Domestic Mortgage Application Form

HSBC Domestic Mortgage

Application Form

We recommend that you ﬁll in this form prior to the

meeting in order that your Mortgage Arranger has

special information regarding your requirements.

Privacy Notice

We will collect and use your information as set out within our

Privacy Notice. You can ﬁnd a copy of our Privacy Notice on

our website at ciiom.hsbc.com/privacy/.

How to ﬁll in the form

Please complete written answers in capital letters and tick

boxes where appropriate. This will help us to process your

application quickly.

Depending on your requirements, not all sections may need to

be completed. Please read the notes at the top of each section

to see if you need to complete that section.

Documents we will need to see

If you are an employee we need to see your last three

months’ payslips. We also require evidence of any guaranteed

allowances, commission or bonuses that you wish to be

considered as an income, together with two years’ Notice of

Assessment.

If you are self-employed we need to see accounts prepared and

signed for the last two years.

We will need to see full details of your current monthly

expenditure, including existing loan and credit card payments

and other contractual payments.

If you do not hold your main current account with us we will

need to see your current account statements for the last three

months showing all commitments.

Before we can complete your application we will need to see

some form of identiﬁcation such as:

• A valid full passport.

We will also need to verify your current address. An original of

one of the following documents is acceptable:

• Bank or building society statement – showing activity within

the last four months.

• Utility bill – dated within the last four months (mobile phone

bills are not acceptable).

• Parish rates bill or water bill – valid for the current year.

Returning your completed form

Before you return the form please check:

• You have answered all the necessary questions.

• All applicants have signed the form.

• All required Direct Debit mandates have been completed

and signed.

• You are submitting all the documents needed.

Please return your completed application form and all

documentation to your nearest branch.

Help

If you need more information about how to apply for

a Mortgage or HomeOwner Loan:

• Call us on 03456 006 161 for Channel Islands and

Isle of Man residents.

• Come into branch and speak to one of our

Mortgage Arrangers.

Section 1A: Your Personal Details

Applicant 1

Title: Mr:

Mrs: Miss: Ms: Dr: Other (please specify):

Surname:

Previous Surnames

(if applicable):

First Name(s):

Residential Address:

Post/Zip Code:

Residential Status:

Marital Status: Single: Married/Civil Partner: Divorced: Separated: Widowed:

Other:

Date of Birth:

D D M M Y Y Y Y

Country of Residence:

Sort Code:

– –

Account Number:

Do you currently have a If Yes, please provide your

mortgage with HSBC? Yes

No mortgage reference number:

Applicant 2

Title: Mr:

Mrs: Miss: Ms: Dr: Other (please specify):

Surname:

Previous Surnames

(if applicable):

First Name(s):

Residential Address:

Post/Zip Code:

Residential Status:

Marital Status: Single: Married/Civil Partner: Divorced: Separated: Widowed:

Other:

Date of Birth:

D D M M Y Y Y Y

Country of Residence:

Sort Code:

– –

Account Number:

Do you currently have a If Yes, please provide your

mortgage with HSBC? Yes

No mortgage reference number:

Section 1B

Applicant 1

Date moved to

current address:

D D M M Y Y Y Y

If you have lived at your present address for less than three years please give your previous address:

Residential Address:

Post/Zip Code:

Applicant 2

Date moved to

current address:

D D M M Y Y Y Y

If you have lived at your present address for less than three years please give your previous address:

Residential Address:

Post/Zip Code:

(Only complete if dierent to ﬁrst applicant’s details).

THINK CAREFULLY BEFORE SECURING OTHER DEBTS AGAINST YOUR HOME. YOUR HOME

MAY BE REPOSSESSED IF YOU DO NOT KEEP UP REPAYMENTS ON YOUR MORTGAGE.

Section 2: Contact Details

All applicants should complete this section.

We will send correspondence to the ﬁrst applicant’s address. If you want correspondence sent to a dierent address please give us

the details.

Applicant 1

Correspondence

Address:

Post/Zip Code:

May we contact you

by telephone? Yes

No Home number:

Daytime number: Mobile number:

Email Address:

Preferred telephone

contact? First Applicant:

Second Applicant:

Preferred time

for contact? Morning:

Afternoon: Evening:

Applicant 2

Correspondence

Address:

May we contact you

by telephone? Yes

Daytime number:

Post/Zip

ode: Hom e number:

Mobile number:

Email Address:

Preferred telephone

contact? First Applicant:

Second Applicant:

Preferred time

for contact? Morning:

Afternoon: Evening:

If you have any Financial Dependants (children), please give details below:

Forenames:

Surname:

Date of Birth:

D D M M Y Y Y Y

Forenames: Surname:

Date of Birth:

D D M M Y Y Y Y

Forenames: Surname:

Date of Birth:

D D M M Y Y Y Y

Forenames: Surname:

Date of Birth:

D D M M Y Y Y Y

Section 3: Employment Details

All applicants should complete this section.

Applicant 1

What is your work status? Employed:

Self-Employed: Not Employed: Retired: Other:

If employed, are you on: Fixed Term Contract: Zero Hour Contract: Other:

If you have more than 1 job,

please provide details:

What is your occupation?

Nature of Business:

(Please note that certain roles aren’t supported when you apply for a mortgage.)

Employer’s Name:

Employer’s address:

(or business address

if self-employed):

Post/Zip Code:

Date you started work

with this employer:

D D M M Y Y Y Y

Are you a If Yes, do you own more than

Company Director? Yes

No 25% of the Company’s shares? Yes No

Applicant 2

What is your work status? Employed:

Self-Employed: Not Employed: Retired: Other:

If employed, are you on: Fixed Term Contract: Zero Hour Contract: Other:

If you have more than 1 job,

please provide details:

What is your occupation?

Nature of Business:

(Please note that certain roles aren’t supported when you apply for a mortgage).

Employer’s Name:

Employer’s address:

(or business address

if self-employed):

Post/Zip Code:

Date you started work

with this employer:

D D M M Y Y Y Y

Are you a If Yes, do you own more than

Company Director? Yes

No 25% of the Company’s shares? Yes No

Section 4: Income Details

All applicants should complete this section.

Applicant 1 Applicant 2

Gross Annual Income: Gross Annual Income:

Earned Income: Earned Income:

Basic Salary:

Guaranteed Overtime:

Guaranteed Bonus/Fees:

Guaranteed Commission:

Other Earned Income:

Total Gross Total Gross

Earned Income:

Unearned Income: Unearned Income:

Rental Income:

Stocks and Shares Income:

Investment Income:

Other Unearned Income:

Total Gross Total Gross

Unearned Income:

Total Gross Total Gross

Annual Income:

Eective Tax Rate:

Net Monthly Income: Net Monthly Income:

Net Monthly Earned Income:

Other Net Monthly Income:

Total Net Monthly Income:

Section 5: Expenditure Details

Do you currently have

a mortgage? Yes

If Yes, please provide details of Existing Borrowing.

Section 5A: Existing Mortgage Details

Applicant 1

Name of Lender:

Address of Lender:

Post/Zip Code:

Whose name(s) is the

loan held in?

Account/Roll Number:

Loan Type: Capital Repayment: Interest Only:

Outstanding Amount of original loan

Balance:

used to purchase property:

Regular Payment Amount:

Frequency of Payments: Monthly: Quarterly: Half-yearly: Annually:

Other (please state):

Remaining Term:

(Please consider any bond fees you might have to pay, if moving lenders – Guernsey only.)

Section 5B: Other Secured/Equity Release Loans

Are there any other loans

secured on the property? Yes

How many?

If Yes, please complete the following information:

Loan 1

Name of Lender:

Lender’s Address:

Post/Zip Code:

Whose name is the loan

held in?

Account/Roll Number:

Loan Type: Capital Repayment: Interest Only:

Loan Purpose:

Outstanding Balance:

Regular Payment Amount:

Is the Loan Protection

Held? Yes

If Yes, please give details:

Frequency of Payments: Monthly: Quarterly: Half-yearly: Annually: Other:

Remaining Term:

years

To be paid o by loan applied for? Yes No

Loan 2

Name of Lender:

Lender’s Address:

Post/Zip Code:

Whose name is the loan

held in?

Account/Roll Number:

Loan Type: Capital Repayment: Interest Only:

Loan Purpose:

Outstanding Balance:

Regular Payment Amount:

Is the Loan Protection

Held? Yes

If Yes, please give details:

Frequency of Payments: Monthly: Quarterly: Half-yearly: Annually: Other:

Remaining Term:

years

To be paid o by loan applied for? Yes No

✔

Loan 3

Name of Lender:

Lender’s Address:

Post/Zip Code:

Whose name is the loan

held in?

Account/Roll Number:

Loan Type: Capital Repayment: Interest Only:

Loan Purpose:

Outstanding Balance:

Regular Payment Amount:

Is the Loan Protection

Held? Yes

If Yes, please give details:

Frequency of Payments: Monthly: Quarterly: Half-yearly: Annually: Other:

Remaining Term:

years

To be paid o by loan applied for? Yes No

Section 5C: Unsecured Loans/Instalment Credit Facilities

Please provide details of all existing facilities.

Loan 1

Please tick box if less than 6 payments remaining:

Name of Lender:

Whose name(s) is the

loan held in?

Loan Type: Personal Loan: Hire Purchase: Other:

Outstanding Balance:

Regular Payment Amount:

Frequency of Payments: Monthly: Quarterly: Half-yearly: Annually: Other:

Remaining Term:

years

To be paid o by loan applied for? Yes No

Is the Loan Protection

Held? Yes

If Yes, please give details:

Loan 2

Please tick box if less than 6 payments remaining:

Name of Lender:

Whose name(s) is the

loan held in?

Loan Type: Personal Loan: Hire Purchase: Other:

Outstanding Balance:

Regular Payment Amount:

Frequency of Payments: Monthly: Quarterly: Half-yearly: Annually: Other:

Remaining Term:

years

To be paid o by loan applied for? Yes No

Is the Loan Protection

Held? Yes

If Yes, please give details:

Loan 3

Please tick box if less than 6 payments remaining:

Name of Lender:

Whose name(s) is the

loan held in?

Loan Type: Personal Loan: Hire Purchase: Other:

Outstanding Balance:

Regular Payment Amount:

Frequency of Payments: Monthly: Quarterly: Half-yearly: Annually: Other:

Remaining Term:

years

To be paid o by loan applied for? Yes No

Is the Loan Protection

Held? Yes

If Yes, please give details:

Loan 4

Please tick box if less than 6 payments remaining:

Name of Lender:

Whose name(s) is the

loan held in?

Loan Type: Personal Loan: Hire Purchase: Other:

Outstanding Balance:

Regular Payment Amount:

Frequency of Payments: Monthly: Quarterly: Half-yearly: Annually: Other:

Remaining Term:

years

To be paid o by loan applied for? Yes No

Is the Loan Protection

Held? Yes

If Yes, please give details:

Please continue in the additional details section at the end of the form if necessary.

Section 5D: Credit Card Facilities

Applicant 1 Applicant 2

Card 1 Card 1

Total Card Limits:

Total Card Balances:

Total Minimum Monthly Total Minimum Monthly

Payment Amounts:

Usual Monthly Usual Monthly

Payment Amount:

Payment Amounts:

Amount to be paid o by Amount to be paid o by

Loan applied for:

Card 2 Card 2

Total Card Limits:

Total Card Balances:

Total Minimum Monthly Total Minimum Monthly

Payment Amounts:

Usual Monthly Usual Monthly

Payment Amount:

Payment Amounts:

Amount to be paid o by Amount to be paid o by

Loan applied for:

Card 3 Card 3

Total Card Limits:

Total Card Balances:

Total Minimum Monthly Total Minimum Monthly

Payment Amounts:

Usual Monthly Usual Monthly

Payment Amount:

Payment Amounts:

Amount to be paid o by Amount to be paid o by

Loan applied for:

Please give details on

card repayments:

Section 5E: Regular Monthly Outgoings/Budget Planner

Current

Housekeeping:

Savings:

Utilities:

Pensions:

TV:

Building Insurance:

Additional Accounts:

Life Insurance:

(Revolut, Monzo, etc.)

Lifestyle:

Other Types of Insurance:

Travel:

Parish Rates:

School Fees:

Other:

Proposed

Housekeeping:

Savings:

Utilities:

Pensions:

TV:

Building Insurance:

Additional Accounts:

Life Insurance:

(Revolut, Monzo, etc.)

Lifestyle:

Other Types of Insurance:

Travel:

Parish Rates:

School Fees:

Other:

Section 6: Property Details

Address of property

on which the loan will

be secured:

Post/Zip Code:

Purchase price (if new What year was

purchase) or estimated

the property built?

current value:

Property Tenure: Freehold:

Leasehold: Share Transfer: Flying Freehold:

If Leasehold: Date of Lease:

D D M M Y Y Y Y

Term of Lease:

years

Ground Rent Payable:

Type of Property: House: Bungalow: Flat: Maisonette: Other:

Is the Property? Detached: Semi-Detached: Terraced:

How many bedrooms What is the property

are there? rebuilding cost?

Amount of incentive/

Source of funds

discount (if any) oered for deposit:

by the seller:

If Share Transfer, is

there a parking space? Yes

If Yes, please give brief

details and parking

space number:

We may require a Professional Valuation of the property, which we will arrange. The Valuation Report will be sent to us

and will remain our property.

It is important that you appreciate that the report is obtained for our purpose only. It does not include a detailed

survey. We make no representation, warranty or guarantee in respect of the purchase price, condition or location of

the property.

You should not rely on the report, or any subsequent oer by us to lend, assist you in deciding on whether to proceed

with the property purchase.

Section 7: Property Ownership Details

Who are/will be the registered owners of the property? (please provide the exact names in which the property will be registered)

Forenames:

Surname:

Forenames: Surname:

Section 8: Property Occupancy Details

All applicants should complete this section.

Are there any other people who are/will be living in the property, and/or who have a ﬁnancial interest in the property? For example,

anyone who has contributed/will contribute to the purchase/alteration/improvement of the property.

Yes

If Yes, please

give details:

We may contact any such parties over 18 years of age who are not the owners in order to obtain their signatures to a Letter of

Consent and Postponement by Deed.

Forenames:

Surname:

Date of Birth:

D D M M Y Y Y Y

Relationship to You:

Forenames: Surname:

Date of Birth:

D D M M Y Y Y Y

Relationship to You:

Please continue in the additional details section at the end of the form, if necessary.

Section 9: Property Use Details

Is/Will the property be

your main residence? Yes

If No, please ask for a new form

Is/Will any part of the

property be let? Yes

If Yes, please

give details:

You will need prior consent from the bank to any letting of the property.

Section 10: Your Requirements

All applicants should complete this section.

Loan Details

What type of First Time Buyer:

Mortgage Transfer: Home Mover: HomeOwner Loan:

borrower are you?

If the HomeOwner loan is in addition to existing borrowing, the borrowers of the new loan must be the same as the main mortgage.

How much do you want to borrow and for how long?

Mortgage: Amount:

Term:

years

Dierence between

purchase price and

loan amount:

HomeOwner Loan: Amount:

Term:

years

Loan purpose?

What type of loan Capital Repayment: Interest Only*:

do you require?

If Interest Only selected, Endowment:

Investments: Second Property: Other:

how do you intend to

repay the borrowing?

If Other, please

give details:

Please note: For an Interest Only mortgage, further information will be required.

What type of interest

rate do you require? Fixed:

Tracker:

For ﬁxed rates, which

ﬁxed term do you

years

require?

Does this application

involve a transfer Yes

of title?

Which pricing package

do you require? Fee Free:

Standard:

Which pricing package

do you require? Booking Fee:

Completion Fee:

If you wish, you can add all or a portion of your booking fee (depending on the size of the fee), and/or all of the completion fee to

your mortgage. This would increase the amount you borrow and as result, the total interest you pay over the term of the mortgage

will be higher than if you paid these fee(s) in full from your own funds at the outset.

*Interest Only Mortgages

With an interest only mortgage, your monthly payment covers only the interest on your loan, enabling you to invest to pay o your

mortgage at the end of the mortgage term or freeing up cash to spend elsewhere.

By repaying only the interest on your mortgage, your monthly payments are lower than with an equivalent capital repayment

mortgage.

Note: You are responsible for making your own arrangements to repay your mortgage at the end of the mortgage term.

This could be through a savings or investment plan. Your property may be repossessed if you do not have sucient

funds to repay the capital balance outstanding at the end of the term.

Repayment details

What is your preferred

day of the month for

repayments?

From what account?

For further information, please call us on 03456 00 61 61* or visit your local branch.

*Lines are open 8am to 10pm every day (24 hours a day if you are an HSBC Premier or Advance Customer).

From outside the Channel Islands & Isle of Man +44 1470 697139.

If you would like to set the amount of your loan repayment at a level over and above the normal monthly payment, please complete

the following questions:

Mortgage HomeOwner Loan

Total amount of monthly

repayment you wish

to make:

Commencement date

of increased payments:

D D M M Y Y Y Y D D M M Y Y Y Y

How long the increased Months: Until Further Notice: Months: Until Further Notice:

payment should be

applied?

HomeOwner Loans Only

All applicants should complete this section.

Money Transmission Details

Would you like the funds to be sent to the same account from which your repayments will be collected? Yes

If No, please give details of where funds should be sent:

Bank/Building Society

Name

Bank/Building Society

Address:

Post/Zip Code:

Name of Account

Holder(s)

Sort Code:

– –

Account Number:

Reference Number:

When do you require

the funds? When Available:

Later Date:

D D M M Y Y Y Y

To Be Advised:

Section 11: Life Assurance Details

All applicants taking an Interest Only mortgage where an endowment policy is the repayment vehicle, should complete this section.

All other applicants should read the important note below only.

Important Note:

For all types of loan, we recommend that protection for the full amount of the loan is in place before any monies are

released to ensure that your loan is repaid in the event of your death. To help you determine your protection goals and

what you would like to happen following an event such as death, disability or loss of income, please contact your local

branch where a member of our team will be happy to arrange an appointment with a Financial Advisor to undertake a

Protection Planning Review with you.

We do require endowment policies of sucient value to cover the loan. If you are arranging new endowment policies,

you must provide us with the Acceptance Notices before we can release any money.

If you have existing endowment policies which you do not want to support your loan, it may not be in your best

interests to surrender them. Please refer to your existing life company for guidance.

If you want us to consider any of your existing endowment policies in support of your mortgage application, please provide the

details below:

Existing Policy Details:

First Policy

Name of Company:

Policy Number:

1st Life Covered: 2nd Life Covered:

Type of Cover:

(eg, ﬁrst event,

second event, single)

Sum Assured:

Start Date:

D D M M Y Y Y Y

Term:

years

Premium Amount:

Premium Frequency: Is the Policy in Trust: Yes No

Location of Policy:

Please enclose your existing policies with this application. If you do not hold the originals please provide us with a copy and state the

originals are held.

Second Policy

Name of Company:

Policy Number:

1st Life Covered: 2nd Life Covered:

Type of Cover:

(eg, ﬁrst event,

second event, single)

Sum Assured:

Start Date:

D D M M Y Y Y Y

Term:

years

Premium Amount:

Premium Frequency: Is the Policy in Trust? Yes No

Location of Policy:

Third Policy

Name of Company:

Policy Number:

1st Life Covered: 2nd Life Covered:

Type of Cover:

(eg, ﬁrst event,

second event, single)

Sum Assured:

Start Date:

D D M M Y Y Y Y

Term:

years

Premium Amount:

Premium Frequency: Is the Policy in Trust? Yes No

Location of Policy:

We may need to contact you at a later date regarding these Policies and your application.

Section 12: Home Insurance Details

All applicants should complete this section in full.

We require that your buildings are adequately insured.

I have existing cover/I will be arranging cover through an insurer of my own choice:

(Please provide details below).

Name of Company:

Company Address:

Post/Zip Code:

Policy Number: Amount of Cover:

Section 13: Details of Professionals Acting for You

Please complete only those sections relevant to your situation:

Solicitor/Conveyancer:

Name of Firm:

Address:

Post/Zip Code:

DX Number: Telephone Number:

Person Acting for You:

Estate Agent:

Name of Firm:

Address:

Post/Zip Code:

Telephone Number:

Person Acting for You:

Solicitor for Independent Legal Advice:

Name of Firm:

Address:

Post/Zip Code:

DX Number: Telephone Number:

Person Acting for You:

Other (please provide details below)

Section 14: Additional Details

Please provide any additional information here:

ciiom.hsbc.com

Accessibility

To ﬁnd out more about our accessible services please visit ciiom.hsbc.com/accessibility or ask at any of our branches.

If you’d like this document in another format such as large print, Braille or audio, please contact

us on 03456 006 161.

BSL Video Relay Service is also available (Monday-Friday 8am-6pm, excluding Bank and Public Holidays).

Issued by HSBC Bank plc, registered in England and Wales number 14259. Registered office 8 Canada Square, London, E14 5HQ. Authorised by the Prudential

Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. HSBC Bank plc, Jersey Branch is regulated by the

Jersey Financial Services Commission for Banking, General Insurance Mediation, Fund Services and Investment Business. HSBC Bank plc, Guernsey Branch is licensed

by the Guernsey Financial Services Commission for Banking, Credit, Insurance and Investment Business. In the Isle of Man HSBC Bank plc is licensed by the Isle of

Man Financial Services Authority.