<......Title......>
	<......First name......>
	<.......Surname.......>
	<.....Date of Birth.....>
	<......Address......>
	<......Since......>
	<......Telephone......>
	<......Mobile......>
	<......Email......>
	<......Marital Status......>
	<......Employer......>
	<......Since......>
	<......Position......>
	< Gross Monthly Income >
Monthly Repayment on Existing Mortgage / Loans
Loan Required (Min. €50,000)
Term Required
Purchase Price Excl. Fees (Min. €75,000)
Purpose of Loan		Make your choice Principal Residence Secondary Residence Buy-to-Let Home Construction Other
Source of Enquiry		Make your choice French Property News Var Village Voice Anglo Info Internet Search Other
Other Information You Consider Relevant