Loan Application

To complete the application form, simply fill in the fields marked with an asterisk (*), then click submit application, it's as easy as that! Remember if you are applying for a loan with a co-buyer or spouse, be sure to click yes to the question above, before you begin to complete this form.

Note: Fields marked with an asterisk ( * ) are recommended, but not mandatory.

Loan Details

Loan Amount

(min. $5000)

Applicant Details

Title:

First Name

Middle Name

Last Name

Date of Birth

Licence No

Licence State

Email Address

Marital Status

Home Phone

Telephone (BH)

Mobile

No. of Dependants

Current Address

Living Arrangement

Unit Number

Street Number

Street Name

Street Type

City/Suburb

State

Post Code

Time At Address

yrs mths*

Landlord Name
(If renting)

Landlord Telephone
(If renting)

Previous Address (If less than 3 years at current address)

Unit Number

Street Number

Street Name

Street Type

City/Suburb

State

Post Code

Time At Address

yrs mths

Primary Employment Details (Please record your last 3 years of employment)

Employment Status

Job Title

Employer Name

Employer ABN

Employer Address

Employer Suburb

State

Employment Contact Person

Employer Telephone

Employed For

yrs mths*

Previous Employment Details (If less than 3 years at current job)

Job Title

Employer Name

Employer Address

Employer Telephone

Employed For

yrs mths

Co-Buyer/Spouse Details (if applicable):
Title:
Given Name		Middle Name
Family Name		Date of Birth
License No		License State
Email Address		Marital Status
Home Phone		Telephone (BH)
Mobile		No. of Dependants
Co-Buyer/Spouse Current Address
Living Arrangement		Unit Number
Street Number		Street Name
Street Type		City/Suburb
State		Post Code
Time At Address	yrs mths
Landlord Name (If renting)		Landlord Telephone (If renting)
Co-Buyer/Spouse Previous Address (if less than 3 years):
Unit Number		Street Number
Street Name		Street Type
City/Suburb		State
Post Code		Time At Address	yrs mths
Co-Buyer/Spouse Primary Employment Details (Please record your last 3 years of employment)
Employment Status		Job Title
Employer Name		Employer ABN
Employer Address		Employer Suburb
State		Employment Contact Person
Employer Telephone		Employed For	yrs mths
Co-Buyer/Spouse Previous Employment (if less than 3 years at current job)
Job Title		Employer Name
Employer Address		Employer Telephone
Employed For	yrs mths
Co-Buyer/Spouse Previous Employment (if less than 3 years at current job)
Job Title		Employer Name
Employer Address		Employer Telephone
Employed For	mths

Income

Borrower Details

Regular Gross Monthly Income

Extra Income (e.g. Family Allowance)

Expenditure

Borrower Details

Rent/Mortgage Payments Per Month

Credit Card Min. Monthly Payment

Other Loan Repayments Per Month

Type of Loan

Loans Reference (Companies you have borrowed money from in the past or at present)

Lenders Name

Loan Type

Loan Term

yrs mths

Monthly Payment

Outstanding Balance (if any)

1st - Personal Reference (Not living with you)

Personal Reference Name

Personal Reference Relationship

Telephone Number (land line)

Unit Number

Street Number

Street Name

Street Type

City/Suburb

State

Post Code

2nd - Personal Reference (Not living with you)

Personal Reference Name

Personal Reference Relationship

Telephone Number (land line or mobile)

Unit Number

Street Number

Street Name

Street Type

City/Suburb

State

Post Code

Bank Account Details

Bank Name

Branch

Additional Information:

Please add any information that may assist us with assessing your loan application.

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.

Appointment to Act

Click here to read the Appointment to act.

I / We have read the Privacy Policy *

I / We are over 18 years of age *

I / We have read the Appointment to Act *