Apply Online - Refinancing Form

First Name *
Second Name
Surname *
Address *
Street No
Street Name
Suburb *

Postcode
State
How long have you lived here?
Years Months
What weekly rent do you pay
$
Date of birth *
Occupation *
Employer
Term of Employment
Years Months
Gross Annual Income *
$
Family Allowance etc.
$ per fortnight
Do you have any other income?
Yes No
Marital Status
Number of Children
Telephone Home
( )
Telephone Mobile
WHAT IS YOUR FINANCE REQUIRED FOR ?
Looking for Better Loan
Yes No
Cash Takeout
Yes No
Business Loan
Yes No
Renovation
Yes No
WHAT LOAN AMOUNT WILL YOU REQUIRE ? *
Who is you current loan with?
Is it Fixed or Variable?
Fixed  Variable
WHAT IS THE ADDRESS OF THE HOME YOU OWN OR ARE REFINANCING?
Street No
Street Name
Suburb
State
Postcode
DO YOU HAVE ANY CREDIT DEFAULTS?
Yes No
PLEASE LIST KNOWN DEFAULTS BELOW (If you do not know what is on your file then we can perform a check as your agent)
Applicant 1
Amount
$
Date Paid
Amount
$
Date Paid
PLEASE LIST ALL CURRENT LOANS
Lender (e.g. GE Finance etc.)
Amount Owing
Monthly Repayments
$
$
$
$
$
$
$
$
PLEASE LIST ALL CREDIT CARDS
Issued by (e.g. ANZ Visa)
Card Limit
Currently Owing
$
$
$
$
$
$
$
$
YOUR CONTACT DETAILS
What is your Email Address? *
What is the best DAYTIME number to phone you on? *
( )
What is the best time during the day to phone you? *
ANY OTHER COMMENTS OR INFORMATION THAT MAY HELP US