1. Referring Broker Details
(If you are not the referral broker please go to Section 2)
Name
Address
Phone
Email
ACL
2. INDIVIDUAL APPLICANT/TRUSTEE OR DIRECTOR - Applicant 1
Borrowing Entity
Surname
Given Names
Address (Home)
Address (Postal)
Email
Marital Status
Single
Married
Divorced
Widowed
Number of Depedants
D.O.B
Drivers License Number
Drivers License Expiry
Occupation
Employer
Gross Income p.a
Residential Status
Australian Citizen
Permanent Resident
Temporary Resident
Non Resident
Employment Status
Full Time
Part Time
Casual
Self Employed
Contractor
Pensioner
Unemployed
Retired
Assets
Property 1 Address
Property 1 Value
Property 2 Address
Property 2 Value
Property 3 Address
Property 3 Value
Vehicle 1
Vehicle 1 Value
Vehicle 2
Vehicle 2 Value
Vehicle 3
Vehicle 3 Value
Cash On Hand Value
Cash On Hand Institution
Superannuation Value
Superannuation Institute
Shares/Investments Value
Shares/Investments Institute
Deposits Paid
Deposits Paid Value
Other Assets
Other Assets Value
Politically Exposed Persons (PEP’s)
Yes
No
Liabilities
Lender Mortgage 1
Lender Mortgage 1 Limit
Lender Mortgage 1 Owing
Lender Mortgage 2
Lender Mortgage 2 Limit
Lender Mortgage 2 Owing
Lender Mortgage 3
Lender Mortgage 3 Limit
Lender Mortgage 3 Owing
Lender Mortgage 4
Lender Mortgage 4 Limit
Lender Mortgage 4 Owing
Credit Card 1 Bank
Credit Card 1 Limit
Credit Card 1 Owing
Credit Card 2 Bank
Credit Card 2 Limit
Credit Card 2 Owing
Credit Card 3 Bank
Credit Card 3 Limit
Credit Card 3 Owing
2. INDIVIDUAL APPLICANT/TRUSTEE OR DIRECTOR - Applicant 2
Borrowing Entity
Surname
Given Names
Address (Home)
Address (Postal)
Email
Marital Status
Single
Married
Divorced
Widowed
Number of Dependants
D.O.B
Drivers License Number
Drivers License Expiry
Occupation
Employer
Gross Income p.a
Residential Status
Australian Citizen
Permanent Resident
Temporary Resident
Non Resident
Employment Status
Full Time
Part Time
Casual
Self Employed
Contractor
Pensioner
Unemployed
Retired
Assets
Property 1 Address
Property 1 Value
Property 2 Address
Property 2 Value
Property 3 Address
Property 3 Value
Vehicle 1
Vehicle 1 Value
Vehicle 2
Vehicle 2 Value
Vehicle 3
Vehicle 3 Value
Cash On Hand Value
Cash On Hand Institution
Superannuation Value
Superannuation Institute
Shares/Investments Value
Shares/Investments Institute
Deposits Paid
Deposits Paid Value
Other Assets
Other Assets Value
Politically Exposed Persons (PEP’s)
Yes
No
Liabilities
Lender Mortgage 1
Lender Mortgage 1 Limit
Lender Mortgage 1 Owing
Lender Mortgage 2
Lender Mortgage 2 Limit
Lender Mortgage 2 Owing
Lender Mortgage 3
Lender Mortgage 3 Limit
Lender Mortgage 3 Owing
Lender Mortgage 4
Lender Mortgage 4 Limit
Lender Mortgage 4 Owing
Credit Card 1 Bank
Credit Card 1 Limit
Credit Card 1 Owing
Credit Card 2 Bank
Credit Card 2 Limit
Credit Card 2 Owing
Credit Card 3 Bank
Credit Card 3 Limit
Credit Card 3 Owing
COMPANY/TRUST APPLICANT
Company Name
ACN
Trust Name
Trustee Name
ABN
Super Fund?
Yes
No
Gross Income P.A
Income Net of Expenses
Assets
Property 1 Address
Property 1 Value
Property 2 Address
Property 2 Value
Property 3 Address
Property 3 Value
Property 4 Address
Property 4 Value
Vehicle 1
Vehicle 1 Value
Vehicle 2
Vehicle 2 Value
Vehicle 3
Vehicle 3 Value
Cash On Hand Value
Cash On Hand Institution
Shares/Investments
Shares/Investments Value
Deposits Paid
Deposits Paid Value
Other Assets
Other Assets Value
Liabilities
Lender Mortgage 1
Lender Mortgage 1 Limit
Lender Mortgage 1 Owing
Lender Mortgage 2
Lender Mortgage 2 Limit
Lender Mortgage 2 Owing
Lender Mortgage 3
Lender Mortgage 3 Limit
Lender Mortgage 3 Owing
Lender Mortgage 4
Lender Mortgage 4 Limit
Lender Mortgage 4 Owing
Credit Card Bank
Credit Card Limit
Credit Card Owing
Business Loan/Overdraft 1 Bank
Business Loan/Overdraft 1 Limit
Business Loan/Overdraft 1 Owing
Business Loan/Overdraft 2 Bank
Business Loan/Overdraft 2 Limit
Business Loan/Overdraft 2 Owing
Other Liabilities
Other Liabilities Owing
LOAN REQUIREMENT & PURPOSE
First Mortgage
Second Mortgage
Construction Finance
Business Finance
Caveat Loans
ATO & Creditor Finance
LVR Sought
Limit Required
Further Notes
PROPERTIES TO BE MORTGAGED
Property 1 Type
Commercial
Residential
Address
Type/Description
Owner Occupied or Investment
Owner Occupied
Investment
Owner/Mortgagor
Estimated Value
Property 2 Type
Commercial
Residential
Address
Type/Description
Owner Occupied or Investment
Owner Occupied
Investment
Owner/Mortgagor
Estimated Value
Property 3 Type
Commercial
Residential
Address
Type/Description
Owner Occupied or Investment
Owner Occupied
Investment
Owner/Mortgagor
Estimated Value
Property 4 Type
Commercial
Residential
Address
Type/Description
Owner Occupied or Investment
Owner Occupied
Investment
Owner/Mortgagor
Estimated Value
Signatures and Acknowledgement:
By signing this application form, you are confirming that the information provided is true and correct in every aspect of the detail provided.
1. Signature of applicant/guarantor/director:
Date
2. Signature of applicant/guarantor/director:
Date
3. Signature of applicant/guarantor/director:
Date
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