Easy Online Application Form

Purpose for loan:

Mandatory fields marked with *

Purpose for loan:	*
Other: (specify)
To Costs to be financed:	*
Less own funds:	*
Total Loan required:	*
Preferred broker:

Personal details

Mandatory fields marked with *

Applicant 1

Applicant 2

Existing customer?	Yes No *
Family Name:	*
Given Names:	*
Title:	*
Sex:	Male Female *
Date of Birth:	DD: MM: YY *
Marital Status:	*
Dependents:	*
Ages: (type age of each dependent separated by comma)
Driver's licence No:	*
Home phone:	*
Work phone:
Fax:
Mobile:
Email Address:	*
Preferred contact method:	Email Phone Mobile Fax Mail

Existing customer?	Yes No
Family Name:
Given Names:
Title:
Sex:	Male Female
Date of Birth:	DD: MM: YY
Marital Status:
Dependents:
Ages: (type age of each dependent separated by comma)
Driver's licence No:
Home phone:
Work phone:
Fax:
Mobile:
Email Address:
Preferred contact method:	Email Phone Mobile Fax Mail

Address details

Mandatory fields marked with *

Applicant 1

Applicant 2

Current address:	*
Suburb:	*
State:	*
Postcode:	*
How long at this address: (example: 3y 7m)	*
Postal address: (if different to above)
Postal Suburb:
Postal State:
Postcode:
New address after settlement: (if different to above)
New Suburb:
New State:
New Postcode:
	If you have lived at your current address for less than three years, please complete below:
Previous address:
Previous suburb:
Previous State:
Previous Postcode:
How long at previous address: (example: 3y 7m)

Current address:
Suburb:
State:
Postcode:
How long at this address: (example: 3y 7m)
Postal address: (if different to above)
Postal Suburb:
Postal State:
Postcode:
New address after settlement: (if different to above)
New Suburb:
New State:
New Postcode:
	If you have lived at your current address for less than three years, please complete below:
Previous address:
Previous suburb:
Previous State:
Previous Postcode:
How long at previous address: (example: 3y 7m)

Employment details

Mandatory fields marked with *

Applicant 1

Applicant 2

Current employer:	*
Name:	*
Address:	*
Position:
Industry:
Employee type:
Taxable Income (per year):	*
How long at current Employment: (example 3y 10m)	*

Current employer:
Name:
Address:
Position:
Industry:
Employee type:
Taxable Income (per year):
How long at current Employment: (example 3y 10m)

Statement of Assets (What you own) For joint applications please combine assets

Properties owned

Property Location

Monthly Income

Estimated Value

Vehicles Owned

Year / Make

Estimated Value

Bank account/term deposit / shares / other investments

Institution:

Monthly Income

Estimated Value

Superannuation

Institution

Present Value

Home Contents Insurable

Insurance Company

Present Value

Other Assets/Income

Description

Monthly Income

Estimated Value

Family Assistance
Do you receive Family Assistance?	Yes No
If "Yes", how much?

Statement of Liabilities (What you owe) For joint applications please combine liabilities

Mortgages

Mortgage to

Monthly Payment

Amount Owing

Lease / hire purchase / personal loans / other liabilities

Monthly Payment

Amount Owing

Credit cards and credit accounts

Company

Type

Limit

Amount Owing

Rent

Real Estate / Landlord

Rent Per Month

Tax / Provisional Tax

Description

Tax Per Month

Applicant(s) must read and agree to the terms and conditions listed below before continuing

Terms and Conditions

I Agree with Terms and Conditions *You must agree with terms and conditions.

STOP! Please check your details one more time before hitting the submit button thank you!