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Mortgage reference application

This form should be used to request a mortgage reference from Dudley Council, on behalf of a mortgage applicant/customer. The request can be submitted by the mortgage company or the mortgage applicant.

The reference will not be issued until Dudley Metropolitan Borough has received payment. You will have an opportunity to pay by debit or credit card by using the "Pay Now" button at the end of the form. Alternatively, you can send a cheque made payable to Dudley Metropolitan Borough Council, please quote "Mortgage Reference" and the property address on the reverse of the cheque. Cheques should be posted to the correspondence address given below.

The reference will be posted directly to the mortgage company only if the tenant(s) have given prior written authority. Authority letters should be forwarded to the correspondence address given below:

Rent Accounting (Mortgage Reference)
Place Directorate
Harbour Buildings
Waterfront West
Brierley Hill
West Midlands


Data Protection Statement

The information you provide on this form is subject to the provision of the Data Protection Act 1998. The information will be held confidentially and will be retained for the purposes of processing your application and meeting our statutory obligations.

Please refer to our Privacy & Disclaimer Statement below for our Information Charter and general information on our approach to security, confidentiality, data collection, etc.

Further data protection information can be obtained from the Information Commissioner's website at

Online payment

This service requires an online payment:

  • You will be taken to the secure payment facility upon submission of this form
  • You need a valid debit or credit card.
  • A payment of £30.00 is required
  • Your application will not be processed until payment has been received
  • The online payment facility is not available from 7:45 pm to 8:15 pm, Monday to Saturday.
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