Ballymena Investment Centre

Enquiry Form

Please fill in all the required fields below and press the Send button when completed.

Please note:

Your home may be repossessed if you do not keep up repayments on your mortgage.

Client 1, Full Name:

Client 2, Full Name:

Client 1, Date of Birth:

Client 2, Date of Birth:

Email Address:

Home Phone:

Client 1, Mobile Phone:

Client 2, Mobile Phone:

What is the best time for us to contact you?:

Who should they best contact to discuss this application:

UK Home Address:

UK Post Code:

Type Required:

Valuation Price:

Mortgage Sum Required:

Source of Deposit:

Mortgage Duration:

Property Position:

How soon do you need the mortgage:

Mortgage Redemption Penalty:

Existing Mortgage Outstanding:

Current Mortgage Lender:

Credit Problems:

Client 1, Current Salary:

Client 2, Current Salary:

Do you receive working family tax credits:

Additional Comments:

Terms & Conditions:

I Agree:

Yes

Important Warning Note:

Please tick box if you do not wish to be contacted about other related products from our introduced companies:

I do not wish to be contacted about any other related products.

Required field