Personal Information
QUOTATION
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Title:
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Mrs
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Date of Birth
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Licence Number
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Licence Card Number
Address
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Street Address
Street Address Line 2
City
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Postal / Zip Code
Years in Current Address
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0
1
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7
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9
10
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12
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15
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Months in Current Address
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0
1
2
3
4
5
6
7
8
9
10
11
Living Arrangement
*
Renting
Own outright
Own with mortgage
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How long have you lived at your current address?
*
0-1 Year
1-2 Years
2-3 Years
3-4 Years
4-5 Years
5+ Years
Previous Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years in Previous Address
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0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
15+
Months in Previous Address
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0
1
2
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5
6
7
8
9
10
11
How long did you live at your previous address?
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0-1 Year
1-2 Years
2-3 Years
3-4 Years
4-5 Years
5+ Years
Adding a Co Borrower
A Co borrower must live with you
Would you like to add a co borrower?
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Yes
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Marital Status:
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Single
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Defacto
Other
Number of Dependents
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0
1
2
3
4
5
6
7
8
9
E-mail
*
Phone Number
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Residency Status
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Citizen
Resident
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What Visa are you on (if Known)
Credit Score
0-200
201-400
401-600
601-800
800+
Unsure
Current Defaults
*
Yes
No
Unsure
How much do your defaults total?
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$0-$250
$251-$500
$501-$1000
more than $1000
Are they paid now?
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Yes
No
Payment plan
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Employment Information
QUOTATION
Current Employer
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Occupation
Employment Type
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Full-time
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ABN Number
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Years in Current Job
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1
2
3
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5
6
7
8
9
10
11
12
13
14
15
15+
Months in Current Job
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0
1
2
3
4
5
6
7
8
9
10
11
Time in current job
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0-1 Year
1-2 Years
2-3 Years
3-4 Years
4-5 Years
5+ Years
Pay After tax
*
Previous Employer
*
Previous Occupation
*
Years in Previous Job
*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
15+
Months in Previous Job
*
0
1
2
3
4
5
6
7
8
9
10
11
Time in previous job
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0-1 Year
1-2 Years
2-3 Years
3-4 Years
4-5 Years
5+ Years
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Applicant 2 Personal Information
No Second Applicant Please Proceed
If you have your Drivers License on you & your information is current please use our quick fill option by selecting 'yes'
Yes
No I will fill in questions
Front of License
*
Back of License
*
Title:
*
Mr
Mrs
Ms
Miss
Dr
Name
*
First Name
Last Name
Date of Birth
*
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Licence Number
*
Marital Status:
*
Single
Married
Defacto
Other
Number of Dependents
*
0
1
2
3
4
5
6
7
8
9
E-mail
*
example@example.com
Phone Number
*
Living Arrangement
*
Renting
Own outright
Own with mortgage
Boarding
Living with parents
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years in Current Address
*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
15+
Months in Current Address
*
0
1
2
3
4
5
6
7
8
9
10
11
Previous Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years in Previous Address
*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
15+
Months in Previous Address
*
0
1
2
3
4
5
6
7
8
9
10
11
Residency Status
*
Citizen
Resident
Non-Resident
What Visa are you on (if Known)
Credit Score
0-200
201-400
401-600
601-800
600+
Unsure
Current Defaults
*
Yes
No
Unsure
How much do your defaults total?
*
$0-$250
$251-$500
$501-$1000
more than $1000
Are they paid now?
*
Yes
No
Payment plan
Unsure
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Applicant 2 Employment Information
No Second Applicant Please Proceed
Current Employer
*
Employment Type
*
Full-time
Part-time
Casual
Contractor
Self employed
ABN Number
*
Years in Current Job
*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
15+
Months in Current Job
*
0
1
2
3
4
5
6
7
8
9
10
11
Pay After tax
*
Previous Employer
*
Previous Occupation
*
Years in Previous Job
*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
15+
Months in Previous Job
*
0
1
2
3
4
5
6
7
8
9
10
11
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Expenses
QUOTATION
Monthly mortgage expense
*
Amount owing on your mortgage
*
Weekly rent/board
*
Do you have any current secured loans?
*
Yes
No
How many?
*
1
2
3
1. Amount Borrowed
*
Lender
*
Monthly Payment
*
Amount Owing
*
2. Amount Borrowed
*
Lender
*
Monthly Payment
*
Amount Owing
*
3. Amount Borrowed
*
Lender
*
Monthly Payment
*
Amount Owing
*
Do you have any current personal loans?
*
Yes
No
How many?
*
1
2
3
1. Amount Borrowed
*
Lender
*
Monthly Payment
*
Amount Owing
*
2. Amount Borrowed
*
Lender
*
Monthly Payment
*
Amount Owing
*
3. Amount Borrowed
*
Lender
*
Monthly Payment
*
Amount Owing
*
How many active credit cards do you currently have?
*
0
1
2
3
4
5
6
7
8
9
1. Lender
*
Limit
*
Amount owing
*
2. Lender
*
Limit
*
Amount owing
*
3. Lender
*
Limit
*
Amount owing
*
4. Lender
*
Limit
*
Amount owing
*
5. Lender
*
Limit
*
Amount owing
*
6. Lender
*
Limit
*
Amount owing
*
7. Lender
*
Limit
*
Amount owing
*
8. Lender
*
Limit
*
Amount owing
*
9. Lender
*
Limit
*
Amount owing
*
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Loan Details
QUOTATION
Loan Amount
*
Loan Term
*
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
Loan Purpose
*
Motorcycle- Private
Motorcycle- Dealer
Car- Private
Car- Dealer
Personal loan
Would you consider a secured loan?
Yes
No
Would like to know more
Vehicle Details
QUOTATION
Vehicle
Vehicle Found
Pre-approval only
Make
*
Model
*
Series
Year
*
Kms/hours
*
Rego number
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Additional Comments:
I authorize prospective Credit Grantors/Lending/Leasing Companies to obtain personal and credit information about me from my employer and credit bureau, or credit reporting agency, any person who has or may have any financial dealing with me, or from any references I have provided. This information, as well as that provided by me in the application, will be referred to in connection with this lease and any other relationships we may establish from time to time. Any personal and credit information obtained may be disclosed from time to time to other lenders, credit bureaus or other credit reporting agencies.
*
YES
I hereby agree that the information given is true, accurate and complete as of the date of this application submission. *
*
YES
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