Home Loan & Finance - Initial Inquiry Form

Home Loan & Finance - Initial Inquiry Form

Basic information we need from you to Refer To Our Preferred Broker for your Situation
Full Name*

First NameMiddle NameLast Name
Mobile Number*
04xx xxx xxx
Email *
example@example.com
Relationship Status*

SingleMarriedDefactoSeparatedDivorcedOther
Residential Status*
Number of Dependents*
Age/s of Above Dependents
e.g. 13, 10, 6
Employment Status*

PAYG - Wage/SalarySelf-EmployedCentrelink RecipientPrivate SuperannuantOther
Self-Employed Status

Sole Trader / PartnershipPrivate CompanyPublic CompanyIndividual Trustee over TrustCorportate Trustee over TrustOther
Current Income (Gross per week) *
Total Weekly Income Amount - Gross (Before Tax)
Loan Amount $*
Amount that I would like to borrow.
Loan Purpose*

Home Loan - PurchaseHome Loan - RefinanceInvestment Loan - PurchaseInvestment Loan - RefinanceSMSF Loan - PurchaseSMSF Loan - RefinanceNDIS/SDA Loan - PurchaseNDIS/SDA Loan - RefinanceRooming / Coliving Loan - PurchaseRooming / Coliving Loan - RefinanceResidential Construction LoanDevelopment FinanceCommercial Construction LoanSmall Personal Loan (up to $2,000)Personal Loan ($2,001 and more)Car (Private)Car (Dealer)UteClassic CarTruckMotorbikeJet SkiBoatTractorTrailerAeroplanePlant / EquipmentCaravanGranny Flat / Transportable HomeShed / Hangar / WorkshopDebt ConsolidationRefinance existing loansReverse Mortage (Seniors' Finance)Other
Credit History*

Perfect Credit FileUnsurePaid DefaultsUnpaid DefaultsEx-BankruptCurrent BankruptCurrent Part 9 Debt AgreementCurrent Part 10 BankruptcyOther
Current Liabilities - Please select all that Apply To You*

No LiabilitiesHome LoanInvestment Property LoanCredit cardStore CardPersonal LoanPayDay Loan (e.g. Nimble, Cash Converters, Cash Train, etc)SPER - Justice PaymentHECS - Education LoanDefaults under arrangmentTax DebtChild MaintenanceOther
Any Additional Information About You That May Help Us Get You A Loan*
Driver Licence Number*
Driver Licence Expiry Date*
Your Name Exactly as shown on your Driver ID*

First NameMiddle NameLast Name
Your Sex (Gender) as shown on Your Driver Licence*
Your Address Exactly as Shown on your Driver ID*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Medicare Card Number*
Medicare Card Expiry Date*
What is the Colour of Your Medicare Card?*
Should be Empty: