First name:
Surname:
Phone:
Email:
Address:
Time at address (e.g. 1 year):
Previous address:
Time at previous address:
Place of birth:
Residency status:
Driver's licence number:
Driver's licence expiry date:
Employment:
ABN/ACN (if self-employed):
Net income per month:
Other income:
Residential status:
Rent/board or mortgage per month:
If mortgage, what is the property value?
If mortgage, how much is owed to the bank?
Credit card limit (if you have one or more):
Personal loans:
Personal loan monthly payment:
Personal loan owing:
Need funding for:
Amount needed:
Deposit amount (if needed):
Do you agree to a credit check?
Bankrupt or discharged in the last 5 years?
Any defaults paid or unpaid?
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