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Applicant Details

Full name of Applicant(s) Borrowers / Co Borrower / Guarantor (Delete as applicable)
Name 1: Phone 1:
Name 2: Phone 2:
Address 1 : For Yrs/ Mths:
Address 2: For Yrs/ Mths:
Post Code 1 : State of Applicant 1:
Post Code 2: State of Applicant 2:
Current Housing Situation: Own Buying Renting Boarding
Customer E-mail Address:
Landlord - Name & Address:
Phone No:
  Marital Status Date of Birth Age of Dependants Drivers Licence No. Expiry Date
1:
2:
  Occupation F/T, P/T, Casual
1:
2:
  Name and Address of Present Employer Phone No. For Years/ Months
1:
2:
  Name and Address of Previous Employer (Min. 3Yrs Req) Phone No. For Years/ Months
1:
2:
Is the Co Borrower contributing to payments? Is the Co Borrower Gaining use of the Goods?
Yes No Yes No

Vehicle and Dealer Details

Dealer/Supplier & Contact Name - Phone Number Broker Name
Make & Model of Goods to be Mortgaged Further Description of Goods to be Mortgaged
Sedan/Hatch/Wag/Ute/4X4 Comp Plate Kilometres Car Details
New Used Auto Manual
Registration No. Vin Chassis No. Engine No. Colour
Full name of Applicant(s) Borrowers / Co Borrower / Guarantor (Delete as applicable)
A/C P/S Cruise C/Locks P/Windows Alloys Airbag Bullbar T/Bar
Commercial Use % Pvt
Description of Trade In Year Value $
Payout Amount $ Finance Company Equity in Trade in $
Finance Reference - Name of Institution Date of Agreement Term in Months Monthly Payments

Particulars of Loan

Full name of Applicant(s) Borrowers / Co Borrower / Guarantor (Delete as applicable)
CASH PRICE : $
Cash Deposit : $
Trade-in : $
Year :  
Type :  
Add lending for Other Purposes (inc. Third Party Debts) : $
   
AMOUNT TO BE BORROWED : $
Comprehensive Insurance : $
Current Insurer : $
Current Registration Number : $
Current Insurance Rating : $
Have you had any accidents (or insurance claims) : $
Any criminal convictions : $

Repayment Structure

Term in Months Repayments Residual/Balloon
Annual % Rate   Depreciation Rate (Lease Only)
Advance Arrears
Other/Seasonal Structure

Statement of Assets and Liabilities

LIABILITIES   ASSETS  
Mortgage Loans : $ Land & Buildings : $
Mortgagee : $ Address of Property : $
Other Loans (Please detail) : $ Plant & Machinery : $
Bank Overdraft – Limit $ : $ Motor Vehicles : $
How secured : $ (Please list vehicles year, make, model) : *
Stock & Trade Accounts : $ Furniture & Fittings Insured Value : $
Credit Cards – Limit $ : $ Cash in Savings or other Accounts : $
Other Liabilities (Please detail) : $ Sundry Debtors : $
    Investments (Please detail) : $
    Other Assets (Please detail) : $
TOTAL LIABILITIES : $ TOTAL ASSETS : $
    LESS TOTAL LIABILITIES : $
    NET ASSETS : $
Have you had any legal proceedings taken against you for debt, been bankrupt, insolvent or assigned your estate?
Yes No
If yes, give details :

Statement of Weekly/ Fortnightly/ Monthly Income and Expenditure

MONTHLY INCOME
(This is the total amount of money you earn - less tax)		 MONTHLY EXPENDITURE
(This is the total amount of money you spend)
Trading Net Profit (if applicable) : $ Rent/Mortgage Repayments : $
Salary (Net) Self : $ Superannuation : $
Salary (Net) Spouse : $ Estimated Home Expenses :
(food, gas, entertainment,
phone, power, clothing)		 $
Other Fixed Income : $ Hire Purchase/Loan Repayments : $
Rental Income : $ Motor Vehicle Expenses : $
Overtime : $ Credit Cards : $
    Other (Details) : $
    New payment for this proposal : $
       
       
TOTAL INCOME : $ TOTAL EXPENSES : $
LESS TOTAL EXPENSES : $    
UNCOMMITTED INCOME : $    

References

Accountant : Contact Name/Phone No. :
Bankers : Branch : Account Type :
Insurance Company : Type of Cover :
Business Reference - Name & Address : Phone No. :
Personal Reference - Name & Address : Phone No. :
Nearest Relative - Name & Address : Phone No. :
Relationship : Phone No. :

I have read the privacy policy as displayed on this website and agree to the terms and conditions.

Yes No

Loan Calculator

Purchase Price
(inc. on-road costs)
Less Trade-In
(if applicable)
Existing Loan
(where required)
Plus Insurance
Loan Total
Loan Term
(in years)
Interest Rate*
(select rate)
Monthly Repayment
* Conditions apply.