Contact details
First name
Middle name
Last name
Mobile number
Email address
Street number and name
Suburb
State
Application details
Client one
Client two
Additional clients
Interview date
Interview time
Loan purpose
Comments/notes
Personal details
Client one
Title
Given name/s
Surname
Relationship status
Date of birth
Permanent resident
Driver's licence number
Licence expiry
Phone (H)
Phone (W)
Phone (M)
Email
Current address
Time there
Renting or owner
Postal address
Previous address
Time there
Number of dependants
Dependants' ages
Mother's maiden name
Client two
Title
Given name/s
Surname
Relationship status
Date of birth
Permanent resident
Driver's licence number
Licence expiry
Phone (H)
Phone (W)
Phone (M)
Email
Current address
Time there
Renting or owner
Postal address
Previous address
Time there
Number of dependants
Dependants' ages
Mother's maiden name
Friend / Relative (not living with you)
Name
Address
Relationship
Phone
Employment history
Client one
Position
Employer
Address
Contact name
Contact phone number
Start date
Probation complete
Previous employer
Address
Phone
Start and finish dates
Client two
Position
Employer
Address
Contact name
Contact phone number
Start date
Probation complete
Previous employer
Address
Phone
Start and finish dates
Solicitor details
Name
Address
Fax
Firm
Phone
Email
Income
Client one
Taxable income
Depreciation
Interest add back
Other
Total
Taxable income
Depreciation
Interest add back
Other
Total
Client two
Taxable income
Depreciation
Interest add back
Other
Total
Taxable income
Depreciation
Interest add back
Other
Total
Company trust
Company ABN / ACN
Company / trust name
Registered address
Business address
Type of trust
Trustee
Beneficiaries
Other
Statement of position
Assets
Address
Value
Address
Value
Address
Value
Address
Value
Lender
Value
Lender
Value
Lender
Value
Make and model
Value
Lender
Value
Type
Value
Type
Value
Value
Value
Liabilities
Lender
Limit
Owing
Repayment
Lender
Limit
Owing
Repayment
Lender
Limit
Owing
Repayment
Lender
Limit
Owing
Repayment
Lender
Limit
Min repayment
Owing
Lender
Limit
Min repayment
Owing
Lender
Limit
Min repayment
Owing
Lender
Limit
Min repayment
Owing
Lender
Limit
Min repayment
Owing
Lender
Limit
Min repayment
Owing
Lender
Limit
Min repayment
Owing
Lender
Limit
Min repayment
Owing
Lender
Limit
Min repayment
Owing
Lender
Limit
Min repayment
Owing
Value
Net asset position
Expenses
Monthly basic living expenses
Child maintenance
Insurance
Private school education
Mobile / internet / pay TV
Private health
Rent / board
Body corporate rates
Additional cars petrol / tolls
Additional cars rego / service
Child care
Subscriptions
Other
Total
Additional information
Features and facilities
Fixed rate loan
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Introductory fixed rate
Basic variable rate
Line of credit
Combination loan
Variable rate loan
Introductory variable loan
Non-conforming
Low doc loan
Seniors loan
Redraw
Offset
Switching
Top ups
Interest only
Portability
Extra repayments
Other
Current financial health
In relation to current enquiries & goals, is the applicant aware of anything which will adversely affect their ability to meet their current & future financial obligations?
Yes
No
Do the applicants anticipate any changes to their income in the next 12 months?
Yes
No
Has the applicant ever had any credit defaults, judgements or previously been made bankrupt?
Yes
No
Estate & planning
Do you have a legal will in place?
Yes
No
What is your anticipated retirement date?
How do you plant to reduce/clear you debt prior to retirement?
Personal insurances
I / we understand that the loss of income will affect my ability to repay my existing or proposed debt. I/we understand that there are insurances available that are designed to help protect my financial position in the event of illness, injury or death.
Yes
No
Do you have any arrangements in place to protect your mortgage/debt existing or concurrent to this application in the event that things go wrong (injury/illness)? (If no, encourage to seek advice or review with change in circumstances?)
Yes
No
Do you have adequate Life Protection insurance in the event of accidental death?
Yes
No
I / we understand that the loss of income will affect my ability to repay my existing or proposed debt. I/we understand that there are insurances available that are designed to help protect my financial position in the event of illness, injury or death.
Yes
No
Insurance needs analysis
I agree that my mortgage adviser has discussed the fact that I should consider looking at covering the debts I currently have through the following:
Life insurance
Income protection insurance
Trauma and Total and Permanent Disability
Knowing this, I would request the following:
I would like to speak to an adviser about the above mentioned insurance. Please ask an Adviser to contact me.
My mortgage adviser has acted appropriately, but I do not wish to be contacted about insurance, thank you.
I acknowledge that every reasonable effort has been made to:
Encourage me to seek advice for my insurance needs.
Explain the risks and possible ramification associated in having inadequate insurance.
Building Insurance
I / we understand that I / we require building insurance and that this building insurance will need to reflect the lender that my / our loan is with.
I / we would like to be referred to a building insurer