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?
Month Year
Date of Birth
Marital Status
Number of Children
Telephone Home
Telephone Mobile
Email Address
Occupation
Status
Employer’s Name
Employer’s Address
Unit No / Street No
Street Name

Suburb
State Postcode
Work Phone Number
Date started?
Month Year
Gross Annual Income
$ per year
Family Allowance etc.
$ per year
Investment Property Rental Income
$ per year
Do you have any other income?
Yes No

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?
Month Year
Date of Birth
Marital Status (as above )
Number of Children (as above )
Telephone Home (as above )
Applicant 2 Mobile Number
Applicant 2 Email Address
Applicant 2 Occupation
Status
Employer’s Name
Employer’s Address
Unit No / Street No
Street Name

Suburb
State Postcode
Work Phone Number
Date started?
Month Year
Gross Annual Income
$ per year
Family Allowance etc.
$ per year
Investment Property Rental Income
$ per year
Do you have any other income?
Yes No

Please tell us 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 acces your account?
InternetBPayPhone
Yes No Don’t Care
Branchs
Yes No Don’t Care
ATMEftposDebit Card
Yes No Don’t Care
Cheque Book
Yes No Don’t Care
Other
Please list ALL your current liabilities.
Liability Type
Amount Owing
Payments
Limit
Refinance?
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
List ALL assests.
Asset
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?
$
Is there anything else that we can assist with?
SolicitorConveyancer
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 us?
Their name:
Anything else you would like to add.