MORTGAGE FORM

 First ApplicantSecond Applicant
First and Last Name *
Marital Status
Household
Residence Address
District
Nearest County Capital
Citizenship
Permanent Residence
E-mail *
Cell Phone *
When Can We Contact You *

Legend:

Date of Birth - Information important for determination whether the applicant would be eligible for a loan, or eventually how long the repayment period would be. Practically all banks limit the applicants by minimum and maximum age for getting the loan.
Number of Persons in the Household - Information important for calculation of the household minimum subsistence level that is being used by some banks for determination of the applicant’s solvency.

* Please fill out all columns marked by an asterisk.

Date of Birth *
Number of Persons in the Household
Number of Children up to 6 Years Old Therefrom
Number of Children from 6 to 10 Years Old Therefrom
Number of Children from 10 to 15 Years Old Therefrom
Number of Dependants from 15 to 26 Years Old Therefrom
Adults Therefrom

Legend:

Correct data about all applicant’s financial liabilities are very important for an exact analysis of the solvency. Please, in your own interest, fill out all your financial liabilities.

* Please fill out all columns marked by an asterisk.

Source of Income *
Duration of Current Employment (Self Employment) in Months *
Amount of NET MONTHLY Income in CZK (when employed) *
Tax Base (Row No. 37) Minus Tax Paid, or the Revenue from the Last Income Tax Return (when self employed)
Amount of Monthly Financial Liabilities for Capital Life Insurance
Amount of Monthly Financial Liabilities for Accident Insurance
Amount of Monthly Financial Liabilities for Real Estate Insurance
Amount of Monthly Financial Liabilities for Building Savings
Amount of Monthly Financial Liabilities for Pension Fund Insurance
Amount of Monthly Financial Liabilities for Leases and Loans
Amount of Other Monthly Financial Liabilities + Specification
Credit Cards and Current Accounts Limits (also not withdrawn amounts)
If you have the building savings, state the name of institution and the amount of saved own fund
In what banks do you have your checking accounts

Legend:

The following information is important for determination of the applicant’s solvency, for determination of the loan purpose and for calculation of the potential state subsidy.
The determined real estate property value is an information important for calculation of the maximum possible amount of the loan. It could be the real estate property the loan is designed for, or it could be another real estate property in personal ownership that will be serving as a collateral. If you have an official estimate of the real estate property value, use the amount stated in that estimate. If you do not fill out any value into this column, we will use the real estate property planned investment total.

Mortgage Location including the County
Planned Amount of Real Estate Investment in CZK (own funds)
Determined Real Estate Value against which the Right of Lien Should Be Exercised, in CZK
Requested Amount of Loan in CZK
Requested Duration of Loan in Years
Is This Your First Mortgage
Loan Will Be Used for
What Type of Real Estate?
 
Will Be the Loan Used for Construction or Purchase of the New Apartment Unit (within 2 years since final inspection)?
Will Be the Building Lot Covered by the Loan?
Estimated Time of Realization (e.g. January, within 1 month, etc.)
Note (max. of 500 characters, write here any important details about the loan, e.g. if it is urgent, write the furthest term of the realization, etc.
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