Client Information Form

APPLICANT 1

Individual
Full Name*

TitleFirst NameMiddle NameLast Name
Preferred name
Date of birth*

DayMonthYear
Date
E-mail*
example@example.com
Alternative E-mail
example@example.com
Mobile phone*
Home phone
Work phone
Gender*
Marital status*
Residency status*
Country of residency*
No. of dependents*
Name*
Date of birth*

DayMonthYear
Date
Name*
Date of birth*

DayMonthYear
Date
Name*
Date of birth*

DayMonthYear
Date
Name*
Date of birth*

DayMonthYear
Date
Current address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Country*
Housing situation*
Date moved in?*

DayMonthYear
Date
Previous address 1
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Country*
Housing situation*
Date moved in?*

DayMonthYear
Date
Previous address 2
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Country*
Housing situation*
Date moved in?*

DayMonthYear
Date
Previous address 3
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Country*
Housing situation*
Date moved in?*

DayMonthYear
Date
No. of app. 1 addresses*
Applicant 1 Next of kin details (in Australia and not living at the same address as you)
Next of kin name*

First NameLast Name
Next of kin address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Next of kin phone*
Next of kin relationship to you*
Your mother's maiden name*

APPLICANT 1

Company/Trust
Full registered name*
ABN*
ACN*
Trading name*
Business activity*
Registered in (state)*
Date incorporated*

DayMonthYear
Date
Company type*

PrivatePublic
Trust name*
Contact person
Full name*

TitleFirst NameMiddle NameLast Name
Preferred name
E-mail*
example@example.com
Alternative E-mail
example@example.com
Mobile phone*
Home phone
Work phone
Registered address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Country*
Principal place of business
Same as registered address?*

YesNo
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Country*
Number of directors*
Director 1 name*
Ownership %*
Director 2 name*
Ownership %*
Director 3 name*
Ownership %*
Director 4 name*
Ownership %*
Director 5 name*
Ownership %*

Applicant 1 Employment History
Current position
Annual gross salary/self-employed income*
Family tax benefit A & B income per fortnight
Other Centrelink income per fortnight
Monthly child support income
Monthly child support expense
Other income (except rental income) per month
Employment status*
Occupation*
Employer name*
ABN*
Employer address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
HR/payroll contact*

First NameLast Name
Employer contact phone number*

Area CodePhone Number
Date started*

DayMonthYear
Date
Previous position 1
Employment status*
Occupation*
Employer name*
Employer address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Employer contact phone number*

Area CodePhone Number
Date started*

DayMonthYear
Date
Previous position 2
Employment status*
Occupation*
Employer name*
Employer address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Employer contact phone number*

Area CodePhone Number
Date started*

DayMonthYear
Date
Previous position 3
Employment status*
Occupation*
Employer name*
Employer address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Employer contact phone number*

Area CodePhone Number
Date started*

DayMonthYear
Date
No. employers for app. 1*

APPLICANT 2
Type of applicant*

IndividualCompany/Trust

APPLICANT 2

Company/Trust
Full registered name*
ABN*
ACN*
Trading name*
Business activity*
Registered in (state)*
Date incorporated*

DayMonthYear
Date
Company type*

PrivatePublic
Trust name*
Contact person
Full name*

TitleFirst NameMiddle NameLast Name
Preferred name
E-mail*
example@example.com
Alternative E-mail
example@example.com
Mobile phone*
Home phone
Work phone
Registered address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Country*
Principal place of business
Same as registered address?*

YesNo
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Country*
Number of directors*
Director 1 name*
Ownership %*
Director 2 name*
Ownership %*
Director 3 name*
Ownership %*
Director 4 name*
Ownership %*
Director 5 name*
Ownership %*

Applicant 2 Employment History
Current position
Annual gross salary/self-employed income*
Family tax benefit A & B income per fortnight
Other Centrelink income per fortnight
Monthly child support income
Monthly child support expense
Other income (except rental income) per month
Employment status*
Occupation*
Employer name*
ABN*
Employer address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
HR/payroll contact*

First NameLast Name
Employer contact phone number*

Area CodePhone Number
Date started*

DayMonthYear
Date
Previous position 1
Employment status*
Occupation*
Employer name*
Employer address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Employer contact phone number*

Area CodePhone Number
Date started*

DayMonthYear
Date
Previous position 2
Employment status*
Occupation*
Employer name*
Employer address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Employer contact phone number*

Area CodePhone Number
Date started*

DayMonthYear
Date
Previous position 3
Employment status*
Occupation*
Employer name*
Employer address
Unit
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Employer contact phone number*

Area CodePhone Number
Date started*

DayMonthYear
Date
No. employers for app. 2*

ASSETS & LIABILITIES
Property values and liabilities

	Value $	Lender	Loan balance $	Monthly repayment $	Fixed / Variable?	Current rate %
Home
Vacant land
Property 2
Property 3
Property 4
Property 5
Property 6
Property 7
Property 8
Property 9
Property 10

Other properties owned
Prop2value
Prop3value
Prop4value
Prop5value
Prop6value
Prop7value
Prop8value
Prop9value
Prop10value
Property 2 address
Property 2 weekly rental income*
Unit*
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Property 3 address
Property 3 weekly rental income*
Unit*
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Property 4 address
Property 4 weekly rental income*
Unit*
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Property 5 address
Property 5 weekly rental income*
Unit*
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Property 6 address
Property 6 weekly rental income*
Unit*
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Property 7 address
Property 7 weekly rental income*
Unit*
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Property 8 address
Property 8 weekly rental income*
Unit*
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Property 9 address
Property 9 weekly rental income*
Unit*
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Property 10 address
Property 10 weekly rental income*
Unit*
Street no.*
Street name*
Street type*
Suburb*
State*
Postcode*
Vehicles owned

	Make	Model
Vehicle 1
Vehicle 2
Vehicle 3
Vehicle 4
Vehicle 5

	Year
Vehicle 1
Vehicle 2
Vehicle 3
Vehicle 4
Vehicle 5

	Value	Loan balance	Monthly payment
Vehicle 1
Vehicle 2
Vehicle 3
Vehicle 4
Vehicle 5

	Lender
Vehicle 1
Vehicle 2
Vehicle 3
Vehicle 4
Vehicle 5

Other assets

	Value
Cash savings
Personal effects / home contents
Superannuation
Shares
Other investments
Other assets

Loans other than home and vehicle

(include ALL debts even if you don't think they are important or they are part of your business)

	Monthly repayment	Balance owed
1 Personal loan
2 Personal loan
3 Personal loan
4 Other
5 Afterpay
6 Certegy
7 Zipmoney/pay

	Lender name
1
2
3
4

Store and credit cards

(include ALL cards even if you don't use them and/or they have zero balance)

	Lender
Card 1
Card 2
Card 3
Card 4
Card 5
Card 6
Card 7
Card 8
Card 9
Card 10

	Limit	Balance
Card 1
Card 2
Card 3
Card 4
Card 5
Card 6
Card 7
Card 8
Card 9
Card 10

CREDIT GUIDE & PRIVACY DISCLOSURE CONSENT
Applicant 1*

First NameLast Name
Date*

DayMonthYear
Date
Applicant 1 email
example@example.com
Applicant 1 mobile
Applicant 1 signature*
Applicant 2*

First NameLast Name
Date*

DayMonthYear
Date
Applicant 2 email
example@example.com
Applicant 2 mobile
Applicant 2 signature*
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I/we do not wish to receive marketing information
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I/we do not wish to receive documents electronically
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