MORTGAGE la FRANAISE - Crédit Agricole Centre Ouest

MORTGAGE à la FRANÇAISE
LOAN APPLICATION FORM
Please specify if the figures you write down are in EUROS (€) or in POUNDS STERLING (£)
Crédit Agricole branch / Agence
Account N° / Compte N°
______________________________ Address
/ Adresse _________________________
_ _ _ _ _ _ _ _ _ _ _ Your phone number / Téléphone_____________________
First Applicant / Emprunteur
Spouse / Conjoint
Joint Applicant / Co-emprunteur
- Surname / Nom _________________________________________ - Surname ____________________________________________
- Forename / Prénom _____________________________________ - Forename ___________________________________________
- Date of birth / Date de naissance __________________________ - Date of birth _________________________________________
Married / Marié(e)
Single / Célibataire
Married
Single
Martial status / Régime matrimonial________________________ Martial status________________________________________
Cohabitation / Concubinage
Cohabitation
Widowed / Veuf(ve)
Divorced / Divorcé(e)
Widowed
Divorced
Alimony / Pension alimentaire _____________________________ Alimony _____________________________________________
- Number of dependants / Nbre pers. à charge _______________ - Number of dependants _______________________________
Main residence / Résidence principale
Main residence
- Address / Adresse _______________________________________ - Address _____________________________________________
_____________________________________________ ____________________________________________
____________ Phone / Téléphone ________________________ ____________ Phone ________________________________
House owner / Propriétaire Since / Depuis ______________ House owner
Since ___________________________
Tenant / Locataire
Since / Depuis ______________ Tenant
Since ___________________________
Living with parents / Au foyer des parents
Living with parents
No house charges / Logé à titre gratuit
No house charges
Employment details / Caractériques Profession
Employment details
Self employed / Non salarié
Employed
Self employed
Employed / Salarié
- Job title / Nature de l’emploi _______________________________ - Job title ______________________________________________
- Name and adress of employer, business / Nom et
- Name and adress of employer, business: _____________
adresse de l’employeur, entreprise: _____________________________ ____________________________________________
_____________________________________________ ____________________________________________
Starting date of employment, business / Date du début de
Starting date of employment, business: _____________
l’emploi, entreprise _________________________________________
_______________________________________________________
If less than 5 years, previous employer / Si moins de 5 ans, If less than 5 years, previous employer:_____________
employeur précèdent _______________________________ ____________________________________________
_____________________________________________ ____________________________________________
Retired / Retraité
Retired / Retraité
- Name and address of pension fund / Organisme de
- Name and address of pension fund___________________
retraite ___________________________________________________ ____________________________________________
Other / Autre ___________________________________________ Other _______________________________________________
Bank details / Banque Actuelle
Bank details
- Name and address of branch / Nom et adresse de l’agence: - Name and address of branch:
_____________________________________________ ____________________________________________
_____________________________________________ ____________________________________________
____________ Phone / Téléphone ________________________ ____________ Phone ________________________________
Open Since / Ouvert depuis ________________________________ Open Since ___________________________________________
If less than 2 years, address and phone of previous
If less than 2 years, address and phone of previous
bank / Si moins de 2 ans, adresse et tél. de la banque précédente
bank _______________________________________
_____________________________________________ ____________________________________________
Address of property to be purchased / Adresse de la Résidence à acquérir :
N°……….... Street / Rue ..................................................... ............................................................................................
Town / Ville ......................................................................... Postcode / Code Postal ..........................................................
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Type of transaction / Type d’opération
Land / Terrain
Building / Construction
Purchase / Acquisition
Renovation works / Travaux
Others/ Autres ________________________________
_____________________________________________
House / Maison individuelle
Flat / Appartement
Financial Plan / Plan de financement
Purchase price / Prix d’achat
Land price / Prix terrain
Buliding price / Coût construction
Renovation price / Prix travaux
- Estate agent fees / frais d’agence
- Notaire fees / Frais de Notaire
Total investment /
__________ €
__________ €
__________ €
__________ €
__________ €
__________ €
_______________ €
Investissment total
Occupation conditions / Conditions d’occupation
Self financing / Autofinancement
__________ €
Main home / Résidence principale
__________ €
Loan requested / Prêt demandé
Secondary home / Résidence secondaire
__________ €
Additional loan / Prêt complémentaire
To be rented / A but locatif
Others / Autres ________________________________
TOTAL
_______________ €
Annual outgoings and Income / Charges et revenus annuels
¾
Annual income / Revenu annuel
First applicant annual income / Salaire emprunteur
_______________
£ or €
- Other income (please specify) / Autres revenus (préciser)
_______________
£ or €
2nd applicant annual income / Salaire co-emprunteur
_______________
£ or €
- Other income (please specify) / autres revenus (préciser)
_______________
£ or €
Total Income / Total revenus :
................................... / 12 =
¾
=A
Annual Outgoings / Charges annuelles :
Current rents / Loyers
____________ £ or €
Mortgage repayments** / Charges habitat
____________ £ or €
Endowment repayments** / Epargne adossée à un
prêt immobilier
____________ £ or €
B/A*
=
%
(outgoing charges)
Other Charges** (loans, credit cards, alimony…) /
Autres charges (prêts conso, cartes de crédits, pensions…)
____________ £ or €
(Present loan annual repayments / Charges annuelles
du projet ) To be added when known.
____________ £ or €
Total Annual Outgoings / Total charges annuelles
................................... / 12 =
=B
* B (Monthly repayments) / A (Monthly income). Your total monthly loan and credit commitments (including the
new loan) should not exceed a 1/3 of your monthly income.
** Please give details page 3
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Assets / Patrimoine
¾
Landed Property / Immeubles
Real estate / Pleine propriété
Lease hold / Bail à long terme
Joint ownership / Copropriété
_____________________________________________
_____________________________________________
_____________________________________________
Total
¾
¾
¾
¾
¾
_____________________________________________
Land aera (approx. value) / Terrain (valeur approx.)
Savings
Securities (shares, etc.) / Titres
Insurances (name of company) / Assurances
Others / autres
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Present debt (mortgage) / Endettement actuel (prêt immobilier)
Lender
/ Prêteur
Balance due
/ Montant dû
Expiry date
/ Date d’échéance
Monthly repayments
/ Mensualités
Guarantee
/ Garantie
Unsecured credit / Crédit en cours
(Personal loans (car, furniture…), credit cards, etc. / Prêts personnels, achats à crédit, cartes de crédit)
Lender
/ Prêteur
Balance due
/ Montant dû
Expiry date
/ Date d’échéance
Given Guarantees / Cautions données
I declare / je déclare :
I have given no guarantees / N'avoir donné aucune caution
I have given the following guarantees / Avoir donné les cautions suivantes :
Amount / montant
Expiry date / date d'échéance
Monthly repayments
/ Remboursements mensuels
Beneficiary / bénéficiaire
Required guarantees / Garanties requises
Mortage on property for which loan is requested / hypothèque conventionnelle en 1er rang
Solicitor / Notaire : ............................................................................................................................................................
Address / Adresse : ...........................................................................................................................................................
........................................................................................................................................................................................
Other guarantees / autres garanties
........................................................................................................................................................................................
........................................................................................................................................................................................
3
Wished mortgage details / Caractéristiques du prêt souhaité
Fixed / Fixe
Variable / Révisable
¾
Rate scale / Barême :
¾
Amount / Montant ________________________
¾
Max. monthly repayment / mensualité max.___________
¾
Max. length / Durée max : _______ Months / Mois
Accidental death or disability insurance / A.D.I. (Assurance Décès Invalidité)
First applicant / Demandeur
100 %
50%
Joint applicant / Co-emprunteur
Other ___ %
Other company / Autre organisme
Name and address / Nom et adresse
__________________________________________
__________________________________________
__________________________________________
100 %
50%
Other ___ %
Other company / Autre organisme
Name and address / Nom et adresse
___________________________________________
___________________________________________
___________________________________________
House insurance/ Assurance Habitation
A comprehensive house insurance policy will be required on the day of the signature of the final act – Crédit
Agricole offers very complete policies : please ask us for information / Une police d'assurance multirisques sera demandée
lors de la signature finale – Crédit Agricole propose des assurances MRH
Occupancy commitment / Engagement du (des) emprunteur(s)
I, the undersigned, undertake: / Je soussigné, m'engage:
¾ to occupy the property personally and with my family / à occuper les lieux avec ma famille
¾ to have the property occupied by a tenant under a let ting lease / à louer avec un contrat de location
I declare on my honour that the information given above is true and accurate, and can be relied upon to form a
material part of the loan agreement / Je déclare sur l'honneur l'exactitude des renseignements ci-dessus qui peuvent servir à réaliser
le prêt.
Date and signature of applicant preceded by
/ Date et signature de l’emprunteur précédé de
"Lu et approuvé"
This document is not a contract.
Please use it to help you and your adviser build up your mortgage together.
A QUICK ANSWER?
SEND THIS FORM BY FAX TO Crédit Agricole HABITAT CONSEIL
+33 (0)5 55 11 92 71
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