INTERMEDIARY SELF
BUILD MORTGAGE
APPLICATION FORM
.
Stage 2 of 2
Please submit this form to:
Self Build Team
Pentland House
8 Lochside Avenue
Edinburgh Park
South Gyle
Edinburgh
EH12 9DJ
It is essential that this form is fully completed by the Intermediary.
TNT 065
Your first name Your last name Company name Company address
Company phone number Company fax number Company email address Preferred email address Alternative email address
Company FCA number Intermediary user ID
Broker name (please print name)
Mortgage application number Date signed
Broker signature
Emails sent to and from Halifax are not secure and could be accessed by an unauthorised person. Whilst we take appropriate measures to safeguard information you provide to us, no email can ever be guaranteed secure.
Any email sent by the Halifax will be restricted to a minimum of application number and brief message including what is required to progress the application to the next stage. The Data Protection Act 1998 restricts the amount of information we can disclose in email messages.
I confirm that I am acting on behalf of the applicant(s) and have their permission to access their information.
I confirm that, to the best of my knowledge and belief, the information contained in this application is true.
I confirm that this application is made in line with the Halifax Self Build policy and understand the application will be declined if it becomes evident this application does not meet the Halifax Self Build criteria.
Intermediary information
Broker declaration
Do you currently own the plot? Yes No
Has any or all of the land been gifted? Yes No
Is the land being or has been separated from either surrounding/adjoining land in the applicant’s or their family’s ownership, or a commercial venture owned by the applicant or their family?
Yes No
Cost of buying the land £
Type of dwelling to be constructed Detached bungalow Detached dormer Detached house
Estimated final value of the property £
Re-confirm loan amount £
Applicant 1 Applicant 2
Personal details
Plot address PostcodeProperty information
Postcode Postcode Postcode Postcode Title Mr/Mrs/Miss/Ms/Dr/Other Forename 1 – as shown on idForename 2 – as shown on id (if applicable) Forename 3 – as shown on id (if applicable) Surname
Current address
Correspondence address
Is the land free of previous dwelling? Yes No
Has build started? Yes No
Builder’s name
If the applicant is the builder what income will they generate whilst the property is £
Please confirm the name of the building standards indemnity scheme provider or whether consultant monitored. Acceptable providers are listed in the new build section of mortgage lending criteria on the Halifax Intermediary Website.
Investment Club Already owned
Housing Assoc. The Coal Authority Builder/ developer Halifax selling as possessor
Who is selling the plot? Normal Local Authority New Town Corporation
Are applicants related to vendor? Where will you live while the property is being constructed?
Will the property be let out once completed?
Completion of property within 2 years ? Will business be carried out at this property?
What is the tenure of the property?
Entry date – Scotland only
Birmingham Midshires –
remortgage details
(only to be completed for remortgage applications) Original purchase price Mortgage account number Outstanding mortgage amount
Please provide details of any improvements you have made to the property (including estimated costs)
Has your home or nearby building been damaged by subsidence, heave, landslip or does it show any signs of cracking or bulging of walls? Yes No Yes No Yes No Yes No Freehold Common hold Leasehold Ownership interest
Remaining term of lease (if leasehold)
£
£
Yes No
Name Contact details if consultant monitored
Address
Yes No
Off road parking
Yes No No. of acres
A garden
Yes No
Road charge liability
Yes No
Is there any other secured lending on the property?
Remortgage only Remortgage & home improvements
How many cars will it garage?
Remortgage & debt consolidation Other Remortgage home improvements & debt consolidation
Will the property have:
A conservatory Yes No
Is there a garage? Yes No
Central heating type Gas Electricity Oil Solid fuel Other
Central heating Full Part None
Accommodation
Please provide the following details about the property
Number of bedrooms Number of bathrooms Number of separate toilets Number of living rooms Number of habitable rooms
Reason for remortgage
Other secured lending
Account number Name of lender
To be repaid or postponed
Loan 1
Loan 2
Loan 3
Repaid Postponed Repaid Postponed Repaid Postponed
Yes No Yes No Yes No
Customer advised if deed of postponement or ranking agreement needed
Forename(s) Surname Forename(s) Surname
Other occupants
Please give the names of anybody aged seventeen or over and not party to the mortgage who will live at the property.Access to the property/land The keys can be obtained from:
Selling agent (if different) Telephone number Evening telephone number Name
Valuation details
Please be aware that we do not allow debt consolidation on remortgage applications from Birmingham Midshires or allow any form of other secured lending on the property whilst still under construction. Where either are identified the application can be declined.
Other contact details
Selling agent’s telephone number Extension
Does your client want the valuation instructing on receipt of the stage 2 form? Has the plot of land already been purchased by your client with their own funds?
If the build has already started it must not be further than the footings/foundation level. Please note that we will not instruct the valuation until the valuation fee has been paid. When your client is ready to pay the valuation fee you will need to contact our processing team who can take payment over the phone via debit/credit card.
Yes No
Yes No
Conveyancers details
Product and fee information
Who is acting for you? Name of firm Address Telephone number Fax number Postcode Yes No
Are you using your own conveyancer?
Provide sub account details
If you have more than three sub account details, refer to section 2 on page 8
Insurance requirements
Has your client arranged Buildings Site Insurance to be in place during the build phase?
The property must be insured. We will contact you with details of our general insurance products and provide no obligation quotes, unless insurance has already been arranged.
Buildings Site Insurance is mandatory as part of this application. Where Buildings Site Insurance is not in place at the start of the build the application will be declined.
Yes No Company Reason for No Yes No Yes No Yes No £ £ £ £ £ £
Supporting information
If you want to provide any additional information to support your application, please use the section below.Section 1 Additional information on project costings Yes No Yes No Yes No Yes No Yes No Yes No £ £ £ £ £ £ £ £ £ £ £ £
Product Code Product type Amount Years MonthsTerm Repayment type Product fee Product fee to be paid upfront
Section 2 Additional information on sub accounts
Section 3 Any other information you feel we might need to know to help us assess your application for a mortgage, in particular, if the loan extends beyond retirement age. Please confirm how you intend to maintain payments.
Easy ways to make your payments
For your convenience monthly payments will be made from a bank/building society using direct debit. Please complete the section below. Payment mandate
Instructions to your bank or building society to pay direct debits
To: The Manager
Bank or Building Society Address
Postcode
Please pay Halifax Direct Debits from the account detailed on this Instruction subject to the safeguards assured by The Direct Debit Guarantee.
I understand that this instruction may remain with Halifax and, if so, details will be passed electronically to my Bank/Building Society.
Name of account holder(s) Bank or Building Society account number Branch sort code
Halifax plc reference number
Signature(s) Date
Banks and Building Societies may not accept Direct Debit Instructions for some types of accounts.
PLEASE RETAIN THIS SECTION FOR YOUR INFORMATION
The Direct Debit Guarantee – this should be retained
• This Guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme.
The efficiency and security of the scheme is monitored and protected by your own Bank or Building Society.
• If the amounts to be paid or the payment dates change, the Halifax will notify you 4 working days in advance of your
account being debited or as otherwise agreed.
• If an error is made by Halifax, a division of Bank of Scotland plc, or your Bank or Building Society, you are guaranteed
a full and immediate refund from your branch of the amount paid.
Originator’s Identification Number 8 8 3 0 0 8