Introducer-HMA - House Of Mortgages

Introducer Form

Introducer Name*
Please give us your name so that we know who has referred to the customer

Customer Name*
Prefix First Last
Customer Telephone Number*
Customer Email Address*
Just in case we cant get hold of you on the phone!
Enter Email Confirm Email

Referral Type*
Which best describes the service the customer is looking for
What is the customer's current position?*
e.g. Property on the market, Currently in rented, Sold subject to contract, Agreement in Principle required ASAP, Purchase 1-3 months/3-6 month.
Additional information*
e.g. How much do they wanting to borrow? Value of deposit. Property information. Their partner's info if its a joint application. Etc.
Consent*
The customer must provide their express consent to be contacted with a view to bringing to their attention, products or services that may be of interest to them with regards to:
- Mortgage products not linked to my/our existing arrangement
- Any other products and services