| First and Last Name:* |
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| Street:* |
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| Suburb:* |
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| State:* |
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| Post Code:* |
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| Email:* |
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| Phone:* |
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| Mobile:* |
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| How would you like us to contact you? |
Email
Phone |
| What is the best time to contact you? |
Anytime
Morning
Afternoon
Evening |
| How did you hear about us? |
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What type of finance would best suit your needs? You may tick more
than one.* |
| Owner occupier loan |
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| First home buyers home loan |
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| Refinancing a current home loan |
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| Credit "impaired" home loan |
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| Investment property loan |
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| Construction loan |
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| 'Over 60's' home loan |
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| Commercial Finance |
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If refinancing,
what is the current balance of your home loan? |
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If purchasing
a property, what is the purchase price?
(or estimated value if refinancing). |
Home |
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| Investment Property 1 |
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| Investment Property 2 |
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| If purchasing a property,
what deposit do you have? |
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What is the total amount of
other debts you have
(personal loans, credit cards, etc)?* |
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| Is the amount above to be refinanced with
this loan? |
Yes
No |
| If it is not to be refinanced, what are
the total monthly payments? |
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| Do you have dependents? If so, how many?* |
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| Please state the age/s of your dependents
(if applicable) |
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| Are you currently working full time? |
Yes
No |
| How long in current job? |
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If PAYG, what is your annual taxable income?
Including other income. eg. (anticipated rent if buying an investment
property)? |
PAYG Partner 1 |
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| PAYG Partner 2 |
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| PAYG Other Income: |
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If Self Employed,
what is your annual taxable income?
Including other income. eg. (anticipated rent if buying an investment
property)? |
SE Partner 1 |
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| SE Partner 2 |
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| SE Other Income: |
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| Are your Tax Returns available? |
Yes
No |
| Do you have clean credit? |
Yes
No |
| If not, please explain why |
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| Comments and questions: |
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Thank you for taking the time to fill out this form. We appreciate
your effort and will contact you soon.
Please click the Submit button when you are ready. |
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| * Required Field |