Get the latest news and views on the financial markets with the Fitzsimons Finance Newsletter. Click here to register for a copy • Bank Shares Down Ahead of NAMA Week • EU Backs Up Rescue Package for Greece Applicant 1 Applicant 2 Name:      *    Address:         Date of Birth (dd/mm/yyyy) :      *    Email Address :         Contact Number:      *    I intend to purchase within:    Select 3 Months 6 Months 1 Year Mortgage Status:    Select First Time Buyer Trading Up Re-Mortgage Investor Other * Property Price: € * Loan Amount required : € * Term of proposed mortgage:    Select 15 Years 20 Years 25 Years 30 Years 35 Years 40 Years *     Employment & Income Details   Occupation:         Employer & Address:         Employment Status:      Select Permanent Part Time Contract Self Employed *    Select Permanent Part Time Contract Self Employed Length of Service:      Years  Months    Years  Months Gross Salary:   € * € Extras e.g. bonuses, overtime p/a, etc         Any Existing Loans:      Yes No    Yes No Purpose of the Loan:     What Financial Institution is Loan with?    Current Loan Balance Outstanding: € Monthly Loan Repayment: € Approximate Maturity Date:      Required fields are denoted by * Fitzsimons Finance, Cutlery Road, Newbridge, Co. Kildare Tel: 045 438438 Fax: 438636 Email:info@fitzsimonsfinance.ie Fitzsimons Life & Pensions Ltd trading as Fitzsimons Finance is regulated by the Financial Regulator