• AEGIS - Financial & Mortgage Advice
  • Registered Address:
  • 38 Dimond Street
  • Pembroke Dock
  • PEMBS SA72 6BT
  • Tel: 0800 008 6250

If at any time you need assistance, freephone 0800 0086250.

30 Second Form

Fill out a short form and an advisor will contact you shortly

 GO!

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30 Second Form

Are you interested in any of these areas? If so, click one below to start the 30 second form. If not, please use the "Contact Us" link.

- Retirement Planning


- Mortgages


- Investments


- Life Assurance


Application Form

This application will be sent to your registered independent adviser who, in accordance with the rules of the Financial Services Authority is legally required to produce a Recommendation / Key Facts Illustration (KFI quotation), before you can proceed with your online application. Please note that this form is not being sent directly to a lender.

Please note the following before continuing.

I/We have downloaded the relevant Initial Disclosure Document........ 

I/We understand that a credit search will be carried out and authorise such a search.....

I/We confirm that I/we have read and understood the Aegis Group "Privacy Statement".....

For your security and peace of mind, data of a sensitive nature will be collected by telephone.
When would you like an adviser to call?

Daytime 
Evening 

Next

Next

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1. Loan and property details

Purpose
Purchase Price/Valuation
Advance Required
Type
Term Required
Source of Deposit
Self Certification Required Yes  No 
Is the property a Flat (or Maisonette) or other?
If Flat or Masonette, how many floors?
Standard Construction Yes   No
If no, Details:
Ex. Local Authority Yes   No 
Property Type
Tenure

Back | Next
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2. Applicants' Details

APPLICANT 1
Full Name
Address Line 1
Address Line 2
Postal Town
Post Code
Resident From dd/mm/yy
                 To dd/mm/yy
Tenure

Prev. if less than 3 years.

Address Line 1
Address Line 2
Postal Town
Post Code
From dd/mm/yy
To dd/mm/yy
Tenure
Contact Telephone
Email Address

Back | Next
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APPLICANT 2
Full Name
Address Line 1
Address Line 2
Postal Town
Post Code
Resident From dd/mm/yy
                 To dd/mm/yy
Tenure

Prev. if less than 3 years.

Address Line 1
Address Line 2
Postal Town
Post Code
From dd/mm/yy
To dd/mm/yy
Tenure

Contact Telephone
Email Address
Back | Next
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Back | Next

Employment and Financial Details

APPLICANT 1

Status
If Employed
Occupation
Time position held
Basic Income
Overtime/Bonus
If Self Employed
2 years accounts ?
Yes     No   
Time Trading

 Years

Months

Accountant

Yes  No


Chart. Cert.

Net Profit last year

Current Mortgage
 (if applicable)
Current Lender
Amount outstanding
Type
Term remaining  years

Payments missed last year
Yes  No 

Number

Payments missed 6 months
Yes  No 

Number 
Receipt of housing benefit

Yes  No 

Back | Next
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Employment and Financial Details

 

APPLICANT 1

 

Adverse Credit Please give details of :-
CCJ's
Loan Arrears
Bankruptcy
IVA
Other

 

Outstanding Debts

Type (Card, HP, Loan, Etc.) Monthly Payment To be redeemed?

 

Do you have? (tick where applicable)
Back | Next
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Back | Next

 

Employment and Financial Details

 

APPLICANT 2

 

Status
If Employed
Occupation
Time position held
Basic Income
Overtime/Bonus
If Self Employed
2 years accounts ?
Yes     No   
Time Trading

 Years

Months

Accountant

Yes  No


Chart. Cert.

Net Profit last year

Current Mortgage
 (if applicable)
Current Lender
Amount outstanding
Type
Term remaining  years

Payments missed last year
Yes  No 

Number

Payments missed 6 months
Yes  No 

Number 



Receipt of housing benefit


Yes  No 

Back | Next
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Back |

Employment and Financial Details

APPLICANT 2

Adverse Credit Please give details of :-
CCJ's
Loan Arrears
Bankruptcy
IVA
Other

 

Outstanding Debts

Type (Card, HP, Loan, Etc.) Monthly Payment To be redeemed?

 

Do you have? (tick where applicable)

Thank you for your enquiry, we will get in contact with you soon.

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