Intermediary MortgageApplication - Leeds …

1 IntermediaryMortgage ApplicationIF YOU HAVE ALREADYRECEIVED OUR AGREEMENTIN PRINCIPLE FOR THIS APPLICATION AND HAVE ANAPPLICATION NUMBER, PLEASEQUOTE IT IN THIS 116/11/2016 07:531 Submission RequirementsAll applications need to be submitted online, via our Intermediary website, This is unless the application falls into one of the following scenarios. A paper based application will be accepted in these instances. Please mark the scenario accordingly. Guarantor Application (A guarantor application form must also be completed) Ported Application Application with more than 2 applicants (3 or 4 applicants an additional application form must be completed).Please refer to our Intermediary website, , for full details of our documentation and fee note, Leeds Building Society only accepts business or consumer applications from mortgage intermediaries where they are providing an advised sales process to customers, with the exception of Buy-to-Let applications.

2 It is the responsibility of the mortgage Intermediary to ensure all legislation including the Financial Conduct Authority rules (including MCOB and the Mortgage Credit Directive Order 2015) on mortgage sales are complied with in Introducer DetailsCompany nameContactEmail AddressCompany addressSTD ( )Telephone noSTD ( )Fax noMobile noPlease indicate Mortgage Club/Network to be 116/11/2016 07:532 Information Required to Process an ApplicationAre you authorised by the FCA For Regulated Mortgages? Yes NoFor Consumer Buy to Let Mortgages? Yes NoFor General Insurance? Yes NoIf yes, please confirm:Your FCA registration number: Whether you are: Directly Authorised An Appointed RepresentativeIf so who is the Principal Principal s FCA No. By signing below I/we confirm that I/we am/are not submitting this application on behalf of another unauthorised no, please confirmWhether you are: A Packager with no client contact(In this case please provide the name of the firm/individual who sold this mortgage together with their FC A number)Name FCA Number Only dealing with Buy-to-Let mortgage businessPlease also confirm, for all applications:What level of advice you provided: Advised Execution only (only applicable for Buy-to-Let applications)Have you charged the applicant(s) a fee for this advice or for arranging this mortgage?

3 Yes NoIf yes, please confirm the cash equivalent of this fee: Do you have a refund policy? Yes NoIf yes, how much will be refunded? I/we acknowledge that it is my/our responsibility to ensure that all legislation including the Financial Conduct Authority rules regarding advised mortgage sales (including MCOB) or the Mortgage Credit Directive Order (as applicable) are complied with in full (except business Buy-to-Let applications) including (without limitation) applicant(s) taking a Right-to-Buy mortgage or where the main purpose for borrowing is for debt have read and printed the Fair Processing Notice and Terms of Business, copies of which are available at and I/we would like to proceed with this (by Introducer): Date: Introduction CertificateI certify that all documents supplied with this application are true copies of original documents seen by myself (please sign and add your company stamp to each separate document).

4 Signed (by Introducer): Date: Fees PayableIf submitting fees with this application please specify the amounts below (this is particularly important where more than one fee is paid by a single payment):Funds Product Fee Application Fee Valuation Fee Transfer Fee Other Fee(s) Please Specify ..Please note that cheques must be made payable to Leeds Building Society, followed by the applicant s name(s). We can no longer accept cheques payable to Leeds Building Society only. Failure to do this will delay the PAGE MUST BE COMPLETED BY THE PROFESSIONAL INTRODUCER INCOMPLETE INFORMATION WILL RESULT IN A DELAY IN PROCESSING THIS APPLICATION. Product ChosenProduct Interest Rate%Type of MortgageStandardBuy-to-LetShared OwnershipOffsetShared EquityHomestakeType of ProductFixed RateDiscounted RateTracker RateCapped RateVariable RateProduct Term*Yr sYr sYr sYr sYr s*NOT MORTGAGE TERM.

5 FOR A 5 YEAR FIXED RATE INSERT 5`. 216/11/2016 07:533 CONFIRMATION OF VERIFICATION OF IDENTITY INTRODUCTION BY AN FCA REGULATED FIRM1. Details of individuals (see explanatory note 1 below)Full name of applicant(s) and date(s) of birthCurrent address (1st Applicant)Current address (2nd Applicant)2. Identi cation reference (see list of acceptable documents shown on page 4)Face to face Non-face to face Postal Telephone (please tick as appropriate)If this is a Non-Face To Face application, please provide details of a 3rd piece of ID for each applicant in the section below*3. Con rmationDocument typeDocument referenceIssuing offi ce/organisationDate of issue/expirytnacilppa dn2tnacilppa ts1 Document typeDocument referenceIssuing offi ce/organisationDate of issue/expirytnacilppa dn2tnacilppa ts1 Document typeDocument referenceIssuing offi ce/organisationDate of issue/expirytnacilppa dn2tnacilppa ts1I/We confi rm that(a)the information set out under sections 1 and 2 above was supplied to me/us by the applicant(s).

6 (b)the evidence I/we have obtained to verify the identity of the applicant(s) (tick one only): Meets the standard evidence set out within the guidance for the UK Financial Sector issued by JMLSG; or Exceeds the standard evidence (written details of the further verifi cation evidence taken are attached to this confi rmation).(c) We confi rm that I/we are unaware of any activities on the part of the above applicant(s) which lead us to suspect that the applicant(s) is/areinvolved in criminal conduct or money laundering.(d) The person signing the form below has seen the applicant(s) identifi cation and is authorised by the fi rm to complete this document.(e) The identity of the applicant(s) has been verifi ed and i) the original documents have been seen ii) any documents requiring a signature werepre-signed and iii) for face to face applications any document with a photograph bore a good likeness to the applicants(s).

7 4. Details of rmExplanatory notes1 A separate confi rmation must be completed for each applicant ( joint holders). Where a third party is involved, a payer of contributions who is different from the applicant, the identity of that person must also be verifi ed, and a confi rmation This form cannot be used to verify the identity of any applicant that falls into one of the following categories:* those who are exempt from verifi cation as being an existing client of the introducing fi rm prior to the introduction of the requirement for such verifi cation* those whose identity has not been verifi ed by virtue of the application of a permitted exemption under the Money Laundering Regulations, or* those whose identity has been verifi ed using the source of funds as This confi rmation must carry an original signature, or an electronic name of regulated fi rmFCA reference numberPrevious address if changed in last 3 monthsPrevious address if changed in last 3 months*For non face to face 16/04/2014 15:30 Page 316/11/2016 07:53 NotesThe following documentation is deemed acceptable for use within section 2:(A) Primary Identi cation: One of the following original documents is required to con rm customer identity.

8 Current signed UK/EU passport Current UK/EU driving licence with photo (full or provisional) EEA member state identity card (Swiss cards also acceptable) Northern Ireland Voter s Card Blue Disabled Driver s Pass Shotgun licence or rearms certi cate HMRC tax noti cation (tax assessment, statement of account or notice of coding; not P45 or P60) Most recent noti cation from Department of Works & Pensions con rming rights to bene ts or state pension (or bene t book)OR Secondary Identi cation: If customer has no primary ID, two of the following original documents may be used: (These should show the customers full name and either the residential address or date of birth.) Current UK driving licence showing current address (non-photo version) A grant letter or student loan agreement from a Local Education Authority Bank, building society or credit card statement (issued within the last 3 months) (not acceptable if printed from the Internet) A cheque guarantee card, credit card or debit card with inlaid holograph Marriage /civil partnership certi cate Deed poll documentation Police warrant cardAddressProof of address is required if the customer is not on the electoral roll.

9 These items must show the full current residential address of the customer. Proof of address is required for the last 3 years. Current UK driving licence with photo or non photo version showing current address Council Local Authority tax bill (valid for current year) HMRC tax noti cation (tax assessment, statement of account or notice of coding; not P45 or P60) A utility bill or prepayment certi cate issued within the last 3 months (not acceptable if printed from the Internet) A mortgage statement from a recognised lender (issued within the last 12 months) A grant letter or student loan agreement from a Local Education Authority Local Council rent card or tenancy agreement (documentation from a private landlord is not acceptable) Bank, building society or credit card statement (issued within the last 3 months) (not acceptable if printed from the Internet) Most recent noti cation from Department of Works & Pensions con rming rights to bene ts or state pension (or bene t book)In respect of joint accounts, ID evidence should be obtained for all account holders.

10 Leeds Building Society reserves the right to seek additional information where it deems necessary, including both income con rmation and identity the event of any enquiry from the law enforcement agencies or regulators in the UK, copies of the relevant customer records referred to above shall be made available under court order or relevant mutual assistance Where a document appears in more than one list above, it can only be used once no single document can be used to verify both identity4and 16/04/2014 15:30 Page 416/11/2016 07:53 Loan Details1 Loan Type Purchase Remortgage Shared Ownership Second Property Right-to-Buy *Buy-to-Let* price (house purchase only) What is the current valuation or approximate value of property (if remortgaging) amount of the property? loan required and over what term Term remortgaging, how much of the loan is for: Please ensure you complete the remortgage authorityRepayment of existing mortgage(s) form at the end of this application raising for Home improvement (please specify, central heating, for bathroom, kitchen)Other (please specify, purchase of land, transfer for of property subject to mortgage, debt consolidation)Is the property registered in the same names as this application?