Please fill this form out and return to me before our appointment. This will speed up the whole process and
    we can spend our time together focusing on your requirements!

    If you are unsure of anything, leave it blank.


    APPLICANT 1

    APPLICANT 2

    Title:

    First and middle names:*

    Surname:*

    Marital status:

    Residential status:

    Date of birth:*

    Do you have dependent children?

    Date of birth of dependent children:

    1.
    2.
    3.
    4.

    Do you have a driver's licence?

    Drivers licence:

    No:
    State:[text app1_licence_state placeholder "State" maxlength:3]
    Expiry:

    No:
    State:[text app2_licence_state placeholder "State" maxlength:3]
    Expiry:

    CURRENT RESIDENTIAL ADDRESS (Please provide last 3 years in total)

    APPLICANT 1

    APPLICANT 2

    Street Address:*

    Post Code:*

    Approx. date you moved into this address:*

    Contact phone numbers:

    Home:
    Work:
    Mobile:*

    Home:
    Work:
    Mobile:

    Email address:*

    Status:

    Monthly Rent ($):

    If renting, agent's name:

    Monthly Rent – App 2 ($):

    If renting, agent's name – App 2:

    Previous address details (if less than 3 years at current address):

    1.

    Yrs:

    Previous address details – App 2:

    1.

    Yrs:

    EMPLOYMENT (Please provide last 3 years in total)

    APPLICANT 1

    APPLICANT 2

    Employer's name (in full):*

    Approx. date you started with current employer:*

    Status:

    Occupation/Job title:*

    Current employer address:

    Contact details:

    Name:
    Phone:

    Name:
    Phone:

    Previous employer's details (if less than 3 years with current
    employer)
    :

    1.

    Yrs:

    Previous employer's details – App 2:

    1.

    Yrs:

    INCOME

    APPLICANT 1

    APPLICANT 2

    Income – gross annual salary (before tax):*

    Gross Overtime / Family Tax A & B / Commission:

    ASSETS: Properties owned


    Owner Occupied Property (O/Occ)

    Address:

    Post Code:

    Value:

    In the name of:




    Investment Property 1

    Address:

    Post Code:

    Weekly Rental:

    In the name of:




    ASSETS: Savings or Cash


    Savings Account 1

    Financial institution:

    In the name of:

    Income Account of:

    Balance:

    ASSETS: Motor Vehicles


    Vehicle 1

    Make:

    Model:

    In the name of:

    Value / Year:


    Yr:[number vehicle_year_1 placeholder "Year" min:1950 max:2030]

    ASSETS: Other Assets


    Home Contents incl Jewellery:

    Shares & Crypto:

    Business Value:

    All Superannuation Balances:

    LIABILITIES: Mortgages


    Mortgage 1

    Name of financial institution:

    Amount currently owing:

    Being Paid Out?

    In the name of:

    Interest Rate & Repayment Type:


    Minimum monthly repayment:

    Secured by:

    Remaining Loan Term (If known):

    [number mortgage_term_yrs_1 placeholder "Yrs" min:0 max:30]
    Yrs
    [number mortgage_term_mths_1 placeholder "Mths" min:0 max:11]
    Mths

    LIABILITIES: Car & Personal Loans & Lease Payments & HECS Balance


    Loan 1

    Name of financial institution:

    In the name of:

    Amount currently owing:

    Monthly repayment:

    Is loan being paid out?

    LIABILITIES: Credit Cards & Store Cards (AfterPay, Interest Free
    Purchases Etc)


    Card 1

    Name of financial institution:

    In the name of:

    Credit limit:

    Amount currently owing:

    Type of card (Visa/Amex etc):

    Is card being paid out?

    MONTHLY LIVING EXPENSES – NOT INCLUDING RENT OR LOAN REPAYMENTS

    1. Utilities – Primary residence cost incl gas, electricity, water:

    2. Transport – fuel, vehicle maintenance, toll:

    3. Food & Groceries – fruit and veg, take away and alcohol:

    4. Clothing/Personal Care – clothes, shoes, beauty:

    5. Phone/Online Subscriptions – mobile, pay tv, internet:

    6. Entertainment – sports, holidays, movies:

    7. Medical & Health – doctor, medicine, gym:

    8. Insurance – Car, home, health:


    9. Education – Private & Public school fees:


    10. Education – Childcare fees:

    11. Other – regular recurring expenses:

    TOTAL:

    $0

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