Loan Amount*

Loan Purpose:*

Description of Goods:*

e.g. 2016 Subaru WRX

Is this a single or a joint application?*

What's your email address?

Enter Email Confirm Email

What's your mobile phone number?*

Have you previously spoken with one of our consultants ?*

How did you first hear about us?

Family and Friends

Google

Facebook

Word of Mouth

Car Sales Person Refered Me

Other

Let's get to know you

What's your name? (as it appears on your drivers licence)*

First Middle Last

What's your date of birth?*

What State is your driver's licence?*

What's your driver's licence number?*

Licence expiry date*

What's your marital status?*

How many dependants do you have?*

Residential Details

You need to provide at least 3 years' worth of residential address details.

In the last 3 years, how many places have you lived?

What's your current address?*

Street Address City State Postcode

How long have you been at this address? (years)*

(months)*

What's your residential status?*

How much rent or board do you pay each week?

What are the contact details of your landlord?*

Previous Address 1

What was your previous address?*

Street Address City State Postcode

What's your residential status?*

How long have you been at this address? (years)*

(months)*

Previous Address 2

What was your previous address?*

Street Address City State Postcode

What's your residential status?*

How long have you been at this address? (years)*

(months)*

Previous Address 3

What was your previous address?*

Street Address City State Postcode

What's your residential status?*

How long have you been at this address? (years)*

(months)*

Tell us about your employment

What type of employment do you have currently?

In the last 3 years how many places have you worked?*

How long have you been employed for at this job? (years)*

(months)*

Do you have any other forms of income? Tick all that apply.

Centrelink Benefit

Family Tax Benefit

Trust Account

Superannuation Benefit

Non-Australian Pension

Armed Forces Benefit

Other Income

Previous Employer 1

How long have you been employed for at this job? (years)*

(months)*

Previous Employer 2

How long have you been employed for at this job? (years)*

(months)*

Previous Employer 3

How long have you been employed for at this job? (years)*

(months)*

Tell us about your Assets & Liabilities

What assets and liabilities do you have? Tick all that apply

Property / Mortgage

Investment Property

Motor Vehicle

Personal Loan

Credit Card

Shares

Which bank is the loan with?*

Shares:

What's the total value of your shares?

Personal & Household Effects:

What's the total value?

Cash In Bank:

What's the total value?

Superannuation:

What's the total value?

What are your weekly living expenses?

Food & Beverage:*

Utilities - Electricity, Rates etc.:*

Communication - Phone, Internet, Cable TV etc.:*

Childcare & Education:*

Travel & Transport - Including new asset, rego, petrol, bus/train fares etc.:*

Insurance - including proposed asset, CTP, building, contents, health, income protection etc.:*

Other:

Total per week:

Tell us about your previous credit history

Have you had any previous credit defaults?*

Who was the default with?*

Has it been paid?*

Why did the default occur?*

Have you been declared bankrupt before?

Have you applied for a credit through a payday lender in the last 12 months?

Who through?*

How Much?*

What is the Balance owing?*