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To help us help you, fill in the fact-find survey below. This preliminary fact-find will enable us to give you a good estimate

If you're not familiar with filling online forms, we can call you back. Simply fill in only the first section, press the 'Call Me Back' button below and we will call you on the contact number given as soon as we are free.


Name
Address
 
Postcode
 
Contact Number
E-mail Address
 

 
Date of Birth
Occupation
 
   
   
Cover required for same address?
If no, please give address
Postcode
 
Type of Property
 
No of bedrooms
House Owned/Rented
If owned, do you have a mortgage?
 
Lender Name
 
Year house was built
Has your home been extended?

Is your home a listed building?

 
Is your home free from defects and in good state of repair?
 
What is the wall construction made of? (Brick,Stone etc)
What is the roof construction made of? (Tiles, Slate etc)
Is any section of your roof flat?
 
If yes, please state percentage %
Will the house be solely occupied by you and your family?
 

Is your home a :
 
Permanent Home
Holiday Home
Weekday Home
 
Weekend Home
 
Other (Please specify)

Is your house usually occupied:
 
During the day
 
At night time
 

Is your home showing any sign of :
 
Subsidence
Ground Heave
Landslip
 
Has your home been underpinned
 
If yes, please say why (flooding, ground heave etc)
Are there any trees within 5 metres of your home?
If so, are they more than 10 metres high?
 

Do you have an approved alarm that is:
 
recognised by NACOSSI?
Regulated by SSAIB or AISC
Do you have working smoke detectors?
 
Are you a member of a Neighbourhood Watch Scheme?
 
I have read, understood and agree to the Data Protection Declaration below


I agree to further contact as described below in Our Future Relationship
 
 

Data Protection Declaration

Gold Mortgage Services will process all information in accordance with the Data Protection Act 1998 and it will be treated as private and confidential now and in the future. The only exceptions to this will be when the law requires us to disclose information or, with your consent, where disclosure is necessary when arranging or servicing your mortgage or protection contracts.

To fulfil our regulatory obligations, we will retain copies of your records for no longer than is necessary or for the duration of any contract you may enter into. You have the right to inspect these records at any time.

 

Our Future Relationship

Our ongoing business relationship with you is important and we would like to be able to contact you by telephone, post or email from time to time to review your mortgage and associated protection product arrangements and introduce other services that may be of interest to you from ourselves or our associated companies.

Gold Mortgage Services is an Authorised Representative of First Complete Ltd which is regulated by the Financial Services Authority.
GMS and Gold Mortgage Services are the trading names of Gold Mortgage Services Ltd. Registered Office 6 Panmure Street, Dundee, DD1 2BW.
Registered in Scotland No: SC242519

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