Home Loan & Finance - Initial Inquiry Form
Basic information we need from you to Refer To Our Preferred Broker for your Situation
Full Name
*
First Name
Middle Name
Last Name
Mobile Number
*
04xx xxx xxx
Email
*
example@example.com
Relationship Status
*
Single
Married
Defacto
Separated
Divorced
Other
Residential Status
*
Home Owner
Home Owner with Mortgage
Renting (Agent)
Renting (Private Arrangement)
Renting (but I have an investment property)
Boarding
Living with Parents / Family
Living with Friends
Employer Provided
Number of Dependents
*
Please Select
None
1
2
3
4
5
6
7
>7
Age/s of Above Dependents
e.g. 13, 10, 6
Employment Status
*
PAYG - Wage/Salary
Self-Employed
Centrelink Recipient
Private Superannuant
Other
Self-Employed Status
Sole Trader / Partnership
Private Company
Public Company
Individual Trustee over Trust
Corportate Trustee over Trust
Other
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 - Purchase
Home Loan - Refinance
Investment Loan - Purchase
Investment Loan - Refinance
SMSF Loan - Purchase
SMSF Loan - Refinance
NDIS/SDA Loan - Purchase
NDIS/SDA Loan - Refinance
Rooming / Coliving Loan - Purchase
Rooming / Coliving Loan - Refinance
Residential Construction Loan
Development Finance
Commercial Construction Loan
Small Personal Loan (up to $2,000)
Personal Loan ($2,001 and more)
Car (Private)
Car (Dealer)
Ute
Classic Car
Truck
Motorbike
Jet Ski
Boat
Tractor
Trailer
Aeroplane
Plant / Equipment
Caravan
Granny Flat / Transportable Home
Shed / Hangar / Workshop
Debt Consolidation
Refinance existing loans
Reverse Mortage (Seniors' Finance)
Other
Credit History
*
Perfect Credit File
Unsure
Paid Defaults
Unpaid Defaults
Ex-Bankrupt
Current Bankrupt
Current Part 9 Debt Agreement
Current Part 10 Bankruptcy
Other
Current Liabilities - Please select all that Apply To You
*
No Liabilities
Home Loan
Investment Property Loan
Credit card
Store Card
Personal Loan
PayDay Loan (e.g. Nimble, Cash Converters, Cash Train, etc)
SPER - Justice Payment
HECS - Education Loan
Defaults under arrangment
Tax Debt
Child Maintenance
Other
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 Name
Middle Name
Last 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
City
State / Province
Postal / Zip Code
Your Medicare Card Number
*
Medicare Card Expiry Date
*
What is the Colour of Your Medicare Card?
*
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