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AToM

SUPPLEMENTARY DIP FORM

Client Names:
Broker Name:

1>> Full Property Details

Is the Property? House     Flat
If a flat, please state:     Purpose Built:     Converted     Ex-Council     Above Shop
Is the Property? Freehold     Leasehold     Remaining lease in years
Full Property Address:
 
 
 
Postcode:
Will this be your primary residence?

Yes      No 

Currently or Previously owned by Local Authority     MOD      Housing Association
Local Authority Built Yes      No 
Number of: Receptions          Kitchens     Bedrooms     Bathrooms
Location:   England     Wales     Mainland Scotland
Tenure : Common Hold     Freehold     Leasehold
Property Type: Studio     Flat     Maisonette     Terrace     Semi     Detached Bungalow or house
Walls: Timber Frame with Brick Skin     Non Standard     Laing Easi Form     Concrete – No fines  
Cross Wall     Modern Method        Standard Construction
Roof: Standard     Thatch     Non Standard     Standard Flat Roof
Year Built:
Agricultural Restrictions Yes      No 
Aware of any past or current structural movement Yes      No 
Property of surrounding area affected by : Landslip     Subsidence     Heave     Settlement     Flooding
Property been Underpinned or similar Yes      No 
Property been extended in last 10 years Yes      No 
Private Sale Yes      No 
   

2>> Vendor Details

Vendors Name:
Vendors Phone Number
Access Arrangements
   

3>> Supplementary Details All Current KFI Questions

Was Sale Advised? Yes      No   Solicitors Fee (defaults to £400)
Intermediary Service Fee Charged? Yes      No   If Yes Amount £      
Packager Application Fee Charged? Yes      No   If Yes Amount £
Packager Valuation Fee Charged? Yes      No   If Yes Amount £      
MPPI Yes      No 
If Yes, please provide details
Any Occupants over 17 Years old Yes      No 
If Yes (Please provide names and date of birth)
 
 
 
   

4>> Solicitors Details

   
AToM to instruct for you? Yes      No 
If no, please provide details of your solicitor including postcode. NB. Solicitor Frm must be registered with the law society and have a minimum of 2 partners.
Solicitor's Address:
 
 
 
Postcode
   
BUILDING INSURANCE  
Lender Block Insurance Quote Yes      No 
If No, please provide details
   

5>> Additional Applicants Details

 
 
National Insurance Number
Employers Name / Company Name
Employment Status Self Employed     Employed     Contracted
Length of Employment
Employers Address
 
 
 
Employers Contact Name
Employers Contact Number
Accountants Name:
Accountants Number
Accountants Address
 
 
 
Accountants Qualifications
Applicant 2
Self Employed     Employed     Contracted

7>> Declaration

Any Lender offer subsequently produced will have been prepared based on the information provided by the financial advisor acting on behalf of the applicant/s. Should any data differ once a fully completed application form has been received this could result in the offer being reassessed and AToM reserve the right to charge any additional valuation fees. E&OE

Please ensure you have checked that all the information is correct and that you have read and understood the declaration above.

Do you agree that you have understood the declaration and wish to proceed.
Yes      No 

 
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