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Complete the form below to start your assessment of your loan.

Please Note: Fields marked with a * are mandatory.

Your Loan Requirements:

Full purchase price: $ *

Loan amount required: $ *

Min. 5,000

Personal Details:

Applicant 1

Applicant 2

First name: *

Surname: *

Mobile No: *

Date of Birth: *

Format: DD/MM/YYYY

Licence No: *

Address Details:

Applicant 1

Applicant 2

Street address: *

Suburb: *

State/territory: *

Telephone (daytime): *

Telephone (after hours): *

Residential status: *

Time at above address: *

If less than 3 years at the above address ...

Time at previous address:

Employment Details:

Applicant 1

Applicant 2

Employment status: *

Occupation: *

Employer/Business name: *

Duration of current employment: *

If less than 3 years with the above employer ...

Duration of previous employment:

Liabilities:

Applicant 1

Applicant 2

Mortgage(Hoam loan)

Bank: *

Amount outstanding: *

Current Vehicle Finance

Bank: *

Amount owing: *

Credit Cards:

Bank: *

Amount owing: *

Bank: *

Amount owing: *

Assets:

Applicant 1

Applicant 2

Real Estate:

Home value: *

Rental property : *

Motor Vehicles:

Make/Model: *

Value: *

Home Contents:

Value: *

Other Assets :

Description:

Value:

Cash:

Bank:*

Amount:*

Financial Details:

Applicant 1

Applicant 2

Your after tax income: $ *

Amount	Frequency

Amount	Frequency

Any additional income?: $

Comments:

Make any additional comments here regarding your situation or requirements.

Contact Details:

Please provide your email address: *

Declaration and Privacy Consent:

Your privacy is important to us. The information that you provide will only be used to prepare your car loan proposal. See our privacy policy for more information.

I/We acknowledge I/we have read and understand the declaration & privacy consent and that the information given by me/us is/will at all times be true and correct and I/we authorise you to contact any person or persons/companies/services listed within the declaration & privacy consent to obtain further information and/or verification of information provided here in or held by the person/persons/company/service.

* Please tick this box if you have read and understand the above statements.

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