ONLINE APPLICATION FORM


Applicant 1 Details

Applicant 1 First Name
Applicant 1 Middle Name
Applicant 1 Last Name
Gender
Address
Unit No  / Street No     
Street Name
Suburb

State Postcode
Date moved in?
Date of Birth
Driver's Licence Number
Exp State
Marital Status
Number of Children
Telephone Home
Telephone Mobile
Email Address
Occupation
Occupation Status
Employer's Name
Employer's Address
Unit No  / Street No     
Street Name
Suburb

State Postcode
Work Phone Number
Date started?
Gross Annual Income
$ per year
Family Allowance etc.
$ per year
Investment Property Rental Income
$ per year

Do you have any other income?

Details of other income

Yes No
Name of nearest relative
(not living with you)
Address
Suburb
State
Postcode
Phone number
Relationship to you
Mother's Maiden Name


Applicant 2 Details

Applicant 2 First Name
Applicant 2 Middle Name
Applicant 2 Last Name
Gender
Relationship to Applicant 1
Address (as above )
Unit No   /   Street No       
Street Name
Suburb

State Postcode
Date moved in?
Date of Birth
Driver's Licence Number
Exp State
Marital Status (as above )
Number of Children (as above )
Telephone Home (as above )
Applicant 2 Mobile Number
Applicant 2 Email Address
Applicant 2 Occupation
Applicant 2 Occupation Status
Employer's Name
Employer's Address
Unit No  / Street No     
Street Name
Suburb

State Postcode
Work Phone Number
Date started?
Gross Annual Income
$ per year
Family Allowance etc.
$ per year
Investment Property Rental Income
$ per year

Do you have any other income?

Details of other income

Yes No
Name of nearest relative
(not living with you)
Address
Suburb
State
Postcode
Phone number
Relationship to you
Mother's Maiden Name


Please tell me what you wish to do with the loan?

Amount you wish to borrow
$ for
How long do you intend to keep this loan?
Years, to


You may choose more than one of the following.
New Home Purchase
Yes No
New Investment Property
Yes No
Refinance Current Loan
Yes No
Refi and Payout Other Debts
Yes No
Build New Home
Yes No
Free Up Equity
Yes No
Refinance Business Debt
Yes No
Buy Vacant Land
Yes No
Reverse Mortgage
Yes No
Self Managed Super Fund Loan
Yes No
Other
Do you quailify for the First Home Owners Grant?
Yes No Not sure
Have you signed a Contract of Sale?
Yes No
If Self Employed do you have your most recent tax returns?
Yes No
Do you have credit defaults?
Yes No


How would you like to access your account?
Internet\BPay\Phone
Yes No Don't Care
Branches
Yes No Don't Care
ATM\Eftpos\Debit Card
Yes No Don't Care
Cheque Book
Yes No Don't Care
Other


Please list ALL current liabilities

Liability Type
Amount Owing
Payments
Limit
Refinance?
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$


Please list ALL assets

Assets
 
Property 1
(as above )
Owner Occupied Investment
Value $
Address
Unit No   /  Street No   
Street Name
Suburb
State Postcode
     
Property 2
Owner Occupied Investment
Value $
Address
Unit No   /  Street No   
Street Name
Suburb
State Postcode
     
Property 3
Owner Occupied Investment
Value $
Address
Unit No   /  Street No   
Street Name
Suburb
State Postcode
     
Motor Vehicle 1
Year Make
$
Motor Vehicle 2
Year Make
$
Shares
 
$
Home & Contents
 
$
Savings
Who with?
$
Savings
Who with?
$
Savings
Who with?
$
Other Assets
What is it?
$
Other Assets
What is it?
$


Can I assist you with anything else?

Solicitor\Conveyancer
Yes No
Home and Contents Insurance
Yes No
Landlords Insurance
Yes No
Protection Insurance
Yes No
Building Inspection
Yes No
Accountant
Yes No
Financial Planner
Yes No
Real Estate Agent
Yes No
Buyer or Sellers Advocate
Yes No


How did you find me?

Their name:


Please offer further comments if you feel it might help me with your loan request.