First Name *

Second Name

Surname *

Address *

Street No
Street Name

Suburb *

State QLD NSW VIC ACT TAS SA WA NT
Postcode

How long have you lived here?

Years Months

What weekly rent do you pay

Date of birth *

Occupation *

Employer

Term of Employment

Years Months

Gross Annual Income *

$

Family Allowance etc.

$ per fortnight

Do you have any other income?

Yes No

Marital Status

Number of Children

Telephone Home

( )

Telephone Mobile

Home Purchase

Yes No

Investment Property

Yes No

Build New Home

Yes No

Buy Vacant Land

Yes No

What is the purchase price or value of the home or investment?

$

Will you be occupying the house yourself?

Yes I/We will be occupying the house.

No, I/We will rent out this investment property

If you are buying an investment house, what weekly rental income do you expect to receive?

Estimated Weekly Rental $

Street No

Street Name

Suburb

State QLD NSW VIC ACT TAS SA WA NT

Postcode

Yes No

$

$

Yes No

Yes No

Applicant 1

Amount

$

Date Paid

Amount

$

Date Paid

Lender (e.g. GE Finance etc.)

Amount Owing

Monthly Repayments

$

$

$

$

$

$

$

$

Issued by (e.g. ANZ Visa)

Card Limit

Currently Owing

$

$

$

$

$

$

$

$

What is your Email Address? *

What is the best DAYTIME number to phone you on? *

( )

What is the best time during the day to phone you? *

AM PM