Personal Quotation
This form may be completed and returned to us to obtain your French mortgage quotation if:
a) You have already found your property in France
b) You have yet to find a property; then simply omit question 1

Purchase Price (€) (excluding fees) Loan amount required(€) (Max 85% of purchase price) Please simply write "MAX" if you would like us to calculate your maximum borrowing capacity. Term Required (anything from 7 to 25 years)
1st APPLICANT
Mr, Mrs, Ms Please select Mr Mrs Ms First Name Surname Date of Birth Nationality Full Address Telephone (home) Telephone (work) E-mail Gross Annual Income (£) Please specify currency if income is not in sterling IF YOU ARE SELF-EMPLOYED, PLEASE GIVE US THE AVERAGE NET INCOME FROM YOUR LAST 2 FINANCIAL YEARS Rental Annual Income (£) Other Annual Income (£) (please specify source e.g., dividends, maintenance received) Monthly Outgoings Mortgage(s) (£ per month) Rent (£ per month) Car Loan (£ per month) Maintenance (£ per month) Other Repayments (£ per month) (Max 85% of purchase price) Please simply write "MAX" if you would like us to calculate your maximum borrowing capacity. Term Required (anything from 7 to 25 years)
2nd APPLICANT
Mr, Mrs, Ms Please select Mr Mrs Ms First Name Surname Date of Birth Nationality Full Address Telephone (home) Telephone (work) E-mail Gross Annual Income (£) Please specify currency if income is not in sterling IF YOU ARE SELF-EMPLOYED, PLEASE GIVE US THE AVERAGE NET INCOME FROM YOUR LAST 2 FINANCIAL YEARS Rental Annual Income (£) Other Annual Income (£) (please specify source e.g., dividends, maintenance received) Monthly Outgoings Mortgage(s) (£ per month) Rent (£ per month) Car Loan (£ per month) Maintenance (£ per month) Other Repayments (£ per month) (Max 85% of purchase price) Please simply write "MAX" if you would like us to calculate your maximum borrowing capacity. Term Required (anything from 7 to 25 years)

UCB mortgages are subject to conditions, please refer to the " Summary Guide" document for further details.
In compliance with the provisions of French Law No. 78-17 of 6 January 1978, called Law ort Information Technology and Liberties, you have a right of access, modification and rectification of all information concerning you. This right is to be exercised by writing to UCB - Consumers department : BP 710 15 44010 Nantes Cedex I France.