EQUITY RELEASE QUESTIONNAIRE   

Name
(First life)

*

Date of birth
(First life)

*    Current Age 
both/sole applicant must be 55+

Marital status
(First life)

please select single married cohabitating separated divorced widowed *

Address*

Telephone Number

*

E-mail address

*

Type of property

Select: House Bungalow Flat *

Is the property freehold or leasehold?

Select: Freehold Leasehold N/a *

If leasehold - number of years left on lease (must be at least 75 years)

What are the walls made of?

Select: Brick Stone Concrete Timber Other *

What is the roof made of?

Select: Tile Slate Thatch Other

Estimated value of property (must be worth at least £40,000 or £50,000 if sheltered accommodation)

£ *

Is there a mortgage and/or loan secured on the property?

Select: Yes No *

(Please note: If there is a mortgage or loan secured it must be paid off from the proceeds)

If yes - how much is outstanding and how long left to run?

£ years

If the amount of equity released is insufficient to repay the loan are you prepared to pay the balance?

Select: Yes No N/a

*Please state the reason you are interested in equity release

*Do you require a minimum amount for a specific purpose?

If yes - how much?

£

(Please note: Under reversion schemes you only receive a percentage of the market value)

*Do you want a Single lump sum/Income /Drawdown scheme?

Have you already discussed this with your family?

If no, please state why

I authorize you to use this information to acknowledge receipt of my information,to communicate with me regarding my enquiry, and to send me relevant information and offers from your company.
(If you do not want to receive information please untick box)

"Equity release" includes home reversion plans and lifetime mortgages. To understand the features and risks, ask for a personalised illustration.

Advice on Money

8a Richfield Avenue
Reading
Berkshire
RG1 8EQ

tel: 0118 958 6421
fax: 0118 958 8431
e-mail: quotes@adviceonmoney-ifa.co.uk

Principal:
Keith Hargraves

Advice on Money is an Appointed Representative of Sesame Ltd who are authorised and regulated by the Financial Services Authority

Sesame is entered on the FSA register under reference 150427