Execution Only Application

Intermediary Product Switch Application

Please note – we do not currently pay Procuration fees to intermediaries for providing advice and submitting an application to us for a Product Switch.

This form provides you with a simple route to submit a product switch request for your client. Please complete the details below and click submit.

Broker Name

Broker Email

FCA Number

Mortgage Account Number

Loan Number

Customer Name

Customer Email

Customer Telephone Number

Have you provided advice to the customer?

Yes

Apply Online to Switch Your Product

You can view the guide to our mortgage services here

You are now just a few steps away from submitting your request, please complete the details below and click submit.

Name *

Last *

Account Number *

Email *

Telephone Number *

Selected Product *

We are able to provide you basic account information if you need this to help with your selection, for example your Loan to Value or account balance. Simply contact us on 01257 235001 (Option 1).

I confirm that I have read the Your Guide to our Mortgage Services and understand that by selecting execution only, the Chorley Building Society is not assessing the suitability of this product for me. I understand that I will not benefit from the protection of the Advised Sales Mortgage Conduct of Business rules on assessing suitability.

We always recommend that you review any personal or property insurance cover you may hold to ensure you are adequately covered, particularly when making a variation to your mortgage.

We work closely with PG mutual, who provide Income Protection Insurance to cover income, if you found yourself unable to work due to illness or accident and unable to meet your financial commitments.

If you would like to be contacted by PG mutual please tick here.

Alternatively click here to get a quotation for this cover.

We work closely with Accord Legal Services, who provide a Will writing and estate planning service, ensuring your assets and loved ones are protected in the best way.

If you would like to be contacted by Accord Legal Services please tick here

If you need further information about insurance and life planning, we suggest you visit www.moneyadviceservice.org.uk

YOUR HOME MAY BE REPOSSESSED IF YOU DO NOT KEEP UP REPAYMENTS ON YOUR MORTGAGE
The Society reserves the right to withdraw all products and incentives without notice.

I confirm that:
• I have verified the customer(s) identity and will retain suitable records of the evidence seen to satisfy identity verification requirements under the Money Laundering Regulations 2007 and the Financial Services and Markets Act 2000. I will make these records available, on request, to Chorley & District Building Society or the Financial Conduct Authority.
• The registration number for the Financial Conduct Authority (FCA) completed above is correct;
• I have complied with the FCA rules in giving advice to the customer(s);
• I have provided the applicant(s) with an accurate ESIS prior to application;
• I am duly authorised to submit this application and am not doing so on behalf of an unauthorised person or firm.

We always recommend that customers review any personal or property insurance cover they may hold to ensure they are adequately covered, particularly when making a variation to their mortgage.

We work closely with PG mutual, who provide Income Protection Insurance to cover income, if they found themselves unable to work due to illness or accident and unable to meet their financial commitments.

If the customer would like to be contacted by PG mutual please tick here.

Alternatively they can click here to get a quotation for this cover.

We work closely with Accord Legal Services, who provide a Will writing and estate planning service, ensuring your assets and loved ones are protected in the best way.

If the customer would like to be contacted by Accord Legal Services please tick here.

If they need further information about insurance and life planning, we suggest you visit www.moneyadviceservice.org.uk