Applicant 1 : Mr Mrs Miss Name : Date of Birth :

occupation : since : self-employed : yes no

Gross annual declared income €uro

Applicant 2 : Mr Mrs Miss Name : Date of Birth :

occupation : since : self-employed : yes no

Gross annual declared income €uro

Monthly Liabilities : Mortgages : Loans : Credit cards :

Maintenance : Rent : Nets assets : property(ies) List :

Investisments : Other :

Financial Plan : purchase price exceptes legal fees : €

legal fees : € works to be carried out : €

Personnal contribution : Mortgage requested : Term : years.

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