Business Introduction Form to Gatehouse Bank.

Eligibility

*I confirm that I am eligible to introduce a customer to Gatehouse Bank and I have registered on the Portal.

Terms of Business

*I have read and accept the Site Terms of Business.

*I have read and accept the Intermediary Terms of Business.

*I have the customer(s) authority to share their details with Gatehouse Bank.

Introducer Details

Please enter your details (as registered on our Portal):

*Introducer name:

Company / Firm / Trading name:

Name of Mortgage Network or Club (if applicable):

*Contact number:

*Email address:

Fee

*Do you wish to receive a fee for this introduction?

Yes

No, I confirm that I will not wish to be paid an Introducer fee for passing the details of the customer(s) to Gatehouse Bank. Please go straight to 'Client Details'.

> Yes – Bank details for payment of the Fee

Please complete the details below if you are FCA registered and are part of a Club or Network.

Network

Club

Name of Mortgage Network or Club to be paid.

If a Network, please provide the FCA number.

I confirm that I am happy to be paid via the Network or Club that I have specified above.

Please note that if you are part of a Mortgage Network or Club you do not have to provide the bank details. We will obtain these from the Mortgage Network or Club directly.

We only accept UK bank account details.

Sort code:

(Please state a six digit sort code only, e.g. a sort code as 12-34-56 should be stated as 123456).

Account number:

(Please state an eight to ten digit account number only, e.g. 12345678 or 1234567890.

Account name:

Email address for remittance statement:

In the case of a Company / Trading name, I confirm these bank details been approved for use by the Company / Trading name.

Client Details

*Total number of applicants:

Please note if there is more than one applicant we will take the other customer(s) details once we have contacted the applicant named on this form.

> Main Applicant

*First name:

*Surname:

*Contact number:

*Email address:

*What is their residency status?

UK resident

UK Expat

International

*Current postcode (for UK customers):

*Country of residency:

Gatehouse Bank will consider finance applications from residents of all countries, except the countries listed in Home Finance Applications - Country Checklist.

*Purpose of finance?

Property purchase

Refinance

*Has your client found a property they wish to purchase?

Yes

*When is your client looking for the finance to be provided?

0-3 months

3-6 months

6+ months

*Preferred method of contact:

Phone

*Employment status

If 'Other' - please supply details here:

*Income (GBP):

(If employed: please state annual gross salary. If self-employed / sole trader: please state net profit)

Case Details

*Case type:

Buy-to-Let (BTL)

Home Purchase Plan (HPP)

*Finance type:

Purchase

Re-finance

*Property value / Purchase price (£):

Expected rental income monthly (£):

Finance amount (£):

The information you have provided will only be used for the purpose of contacting the customer to discuss the case details outlined above. Gatehouse Bank plc will not keep the details above, unless the customer undertakes our services.

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Business Introduction Form