Data Capture Sheet - InReach Finance

Fact Find & Needs Analysis

Personal Details

Applicant 1

Applicant 2

Applying as

Option Apply

Borrower

Guarantor

Option Apply

Borrower

Guarantor

Title

Title

Mrs

Other (specify)Other (specify)

Title

Mrs

Other (specify)Other (specify)

First Name

First Name

Middle Name(s)

Middle Name

Family Name

Family Name

Preferred Name (if different to above)

Preferred Name

Date of Birth

Date of Birth

Marital Status

Marital Status

Single

Married

De Facto

Other

Marital Status

Single

Married

De Facto

Other

Dependents (number & age of each)

Number

Age(s)

Number

Age(s)

Drivers License

Number

Issuing State

Number

Issuing State

Issue date

Expiry date

Issue date

Expiry date

Mother’s Maiden Name

Mother’s Maiden Name

Residency

Permanent Australian Resident

Yes

Permanent Australian Resident

Yes

Status

Citizen

Resident

Non-resident

Status

Citizen

Resident

Non-resident

Country of Residency

Home Phone Number

Phone

Mobile Number

Phone

Email Address

Current Residential Details

Street Address

Suburb

State

Postcode

State

Postcode

Date moved in

Date Moved in

Status

Own

Rent

Other (Specify)Other (Specify)

Status

Own

Rent

Other (Specify)Other (Specify)

Previous Address (if within last 2 yrs)

Street Address

Suburb

State

Postcode

State

Postcode

Date moved in

Status

Own

Rent

Other (specify)Other (specify)

Status

Own

Rent

Other (specify)Other (specify)

Other Notes

Notes

Employment Details

Applicant 1

Applicant 2

CURRENT-Primary

Types & Status

Occupation

Employer Name

Employer Name

Date Commenced

Date

Probation Period

Probation

If yes - end dateIf yes - end date

Probation

If yes - end dateIf yes - end date

CURRENT-Secondary/Other

Types & Status

Occupation

Occupation

Employer Name

Employer Name

Probation Period

Probation period

Yes

If yes - end date

Probation period

Yes

If yes - end date

PREVIOUS - if within last two years

Types & Status

Occupation

Occupation

Employer Name

Employer Name

Period Employed (dd/mm/yy)

From

FINANCIAL POSITION - Monthly Income Expenses

Net Income

Current ($)

Expenses

Current ($)

Primary Employment

Credit Commitments

Applicant 1:

Primary Employment- Applicant 1: Current ($)

Existing mortgage - Primary residence

Existing mortgage - Primary residence Current ($)

Applicant 2:

Primary Employment- Applicant 2: Current ($)

Secondary Employment

Existing mortgage(s) - Investment - total repayments

Existing mortgage(s) - Investment - total repayments Current ($)

Applicant 1:

Secondary Employment- Applicant 1: Current ($)

Applicant 2:

Secondary Employment- Applicant 2: Current ($)

Total Buy Now Pay Later – Afterpay etc

Total Buy Now Pay Later – Afterpay etc Current ($)

Government Benefits (Centrelink/DVA)

Government Benefits Current ($)

Credit Card(s) at 3% of limit

Credit Card(s) at 3% of limit Current ($)

Investment - Property

Store Card(s) & ‘buy now pay later’ plans

Store Card(s) & ‘buy now pay later’ plans Current ($)

Existing - total rent received

Existing - total rent received Current ($)

Personal Loan(s)

Personal Loan(s) Current ($)

Proposed - total rent to be received

Proposed - total rent to be received Current ($)

Vehicle Finance

Vehicle Finance Current ($)

Investments - Other
(e.g. cash, shares, managed funds)

Investments - Other Current ($)

Other e.g. ATO repayment plans, family loans

Other e.g. ATO repayment plans, family loans Current ($)

Overseas Sources - convert to AUD

Overseas Sources - convert to AUD Current ($)

Living Expenses

Other Sources

Other Sources Current ($)

Childcare including nannies

Childcare including nannies Current ($)

Child maintenance

Child maintenance Current ($)

Clothing and personal care

Clothing and personal care Current ($)

Education - public and/or private school fees, uniforms & activities

VEducation - public and/or private school fees, uniforms & activities Current ($)

HECS / HELP

HECS / HELP Current ($)

Groceries - supermarket, meat, fruit & vegetables

Groceries - supermarket, meat, fruit & vegetables Current ($)

Insurances - health, home, contents, life, income protection, pet & voluntary super

Insurances - health, home, contents, life, income protection, pet & voluntary super Current ($)

Investment property utilities, maintenance & other related costs

Investment property utilities, maintenance & other related costs Current ($)

Medical and Health Costs - doctor, dental, optical, and pharmaceutical

Medical and Health Costs - doctor, dental, optical, and pharmaceutical Current ($)

Other unique items

Other unique items Current ($)

Owner occupied property maintenance, utilities, rates, and related costs

Owner occupied property maintenance, utilities, rates, and related costs Current ($)

Recreation and Entertainment - dining out, movies, gifts, memberships, pet care

Recreation and Entertainment - dining out, movies, gifts, memberships, pet care Current ($)

Transport - public, car expenses (petrol, registration, insurance, servicing & tolls)

Transport - public, car expenses (petrol, registration, insurance, servicing & tolls) Current ($)

Rent or Board

Rent or Board Current ($)

TOTAL NET INCOME (A)

TOTAL NET INCOME Current ($)

TOTAL EXPENSES(B)

TOTAL EXPENSES Total Current ($)

NET MONTHLY SURPLUS (A – B)

Total After Settlement ($)

SELF EMPLOYED APPLICANTS (if applicable)

BUSINESS DETAILS & FINANCIAL POSITION

Name of entity

Name of entity (Data)

Type of entity

Type of entity (Data)

ABN/ACN

ABN/ACN (Data)

Registered trading name

Registered trading name (Data)

Trustees (if applicable)

Trustees (if applicable) (Data)

Beneficiaries (if applicable)

Beneficiaries (if applicable) (Data)

Latest Financial Year ($)

Latest Financial Year ($) (Data)

Previous Financial Year ($)

Previous Financial Year ($) (Data)

Years in Operation

Years in Operation (Data)

Financial Complete

Financial Complete (Data)

Last Tax Year Lodged

Last Tax Year Lodged (Data)

TOTAL NET INCOME

TOTAL NET INCOME (Data)

FINANCIAL POSITION - Assets & Liabilities

CURRENT STATUS

Description

Estimated Value ($)

Monthly Income ($)

Ownership

Primary Residence

Primary Residence of description

Primary Residence of Estimated Value ($)

Primary Residence of Monthly Income ($)

Ownership Choices

App 1

App 2

Other Home

Other Home of description

Other Home of Estimated Value ($)

Other Home of Monthly Income ($)

Ownership Choices

App 1

App 2

Investment Property 2

Investment Property 2 of description

Investment Property 2 of Estimated Value ($)

Investment Property 2 of Monthly Income ($)

Ownership Choices

App 1

App 2

Investment Property 3

Investment Property 3 of description

Investment Property 3 of Estimated Value ($)

Investment Property 3 of Monthly Income ($)

Ownership Choices

App 1

App 2

Vehicle 1

Vehicle 1 of description

Vehicle 1 of Estimated Value ($)

Vehicle 1 of Monthly Income ($)

Ownership Choices

App 1

App 2

Vehicle 2

Vehicle 2 of description

Vehicle 2 of Estimated Value ($)

Vehicle 2 of Monthly Income ($)

Ownership Choices

App 1

App 2

Boat/Caravan/Leisure

Boat/Caravan/Leisure of description

Boat/Caravan/Leisure of Estimated Value ($)

Boat/Caravan/Leisure of Monthly Income ($)

Ownership Choices

App 1

App 2

Bank Account 1

Bank Account 1 of description

Bank Account 1 of Estimated Value ($)

Bank Account 1 of Monthly Income ($)

Ownership Choices

App 1

App 2

Bank Account 2

Bank Account 2 of description

Bank Account 2 of Estimated Value ($)

Bank Account 2 of Monthly Income ($)

Checkboxes

App 1

App 2

Bank Account 3

Bank Account 3 of description

Bank Account 3 of Estimated Value ($)

Bank Account 3 of Monthly Income ($)

Ownership Choices

App 1

App 2

Term Deposits

Term Deposits of description

Term Deposits of Estimated Value ($)

Term Deposits of Monthly Income ($)

Ownership Choices

App 1

App 2

Investments/Shares/ Managed Funds

Investments/Shares/ Managed Funds of description

Investments/Shares/ Managed Funds of Estimated Value ($)

Investments/Shares/ Managed Funds of Monthly Income ($)

Ownership Choices

App 1

App 2

Superannuation

Superannuation of description

Superannuation of Estimated Value ($)

Superannuation of Monthly Income ($)

Ownership Choices

App 1

App 2

Contents & Valuables

Contents & Valuables of description

Contents & Valuables of Estimated Value ($)

Contents & Valuables of Monthly Income ($)

Ownership Choices

App 1

App 2

Other (specify)

Other (specify) of description

Other (specify) of Estimated Value ($)

Other (specify) of Monthly Income ($)

Ownership Choices

App 1

App 2

TOTAL ASSETS

TOTAL ASSETS of Estimated Value ($)

TOTAL ASSETS of Monthly Income ($)

CURRENT LIABILITIES

Lender / Loan Type

Balance ($)

Limit ($)

Repayments Monthly ($)

Interest Rate (%pa)

Mortgage - Primary residence

Mortgage - Primary residence of Lender / Loan Type

Mortgage - Primary residence of Balance ($)

Mortgage - Primary residence of Limit ($)

Mortgage - Primary residence of Repayments Monthly ($)

Mortgage - Primary residence of Interest Rate (%pa)

Mortgage - Other home

Mortgage - Other home of Lender / Loan Type

Mortgage - Other home of Balance ($)

Mortgage - Other home of Limit ($)

Mortgage - Other home of Repayments Monthly ($)

Mortgage - Other home of Interest Rate (%pa)

Mortgage - Investment property 1

Mortgage - Investment property 1 of Lender / Loan Type

Mortgage - Investment property 1 of Balance ($)

Mortgage - Investment property 1 of Limit ($)

Mortgage - Investment property 1 of Repayments Monthly ($)

Mortgage - Investment property 1 of Interest Rate (%pa)

Mortgage - Investment property 2

Mortgage - Investment property 2 of Lender / Loan Type

Mortgage - Investment property 2 of Balance ($)

Mortgage - Investment property 2 of Limit ($)

Mortgage - Investment property 2 of Repayments Monthly ($)

Mortgage - Investment property 2 of Interest Rate (%pa)

Mortgage - Investment property 3

Mortgage - Investment property 3 of Lender / Loan Type

Mortgage - Investment property 3 of

Mortgage - Investment property 3 of Limit ($)

Mortgage - Investment property 3 of Repayments Monthly ($)

Mortgage - Investment property 3 of Interest Rate (%pa)

Credit card 1

Credit card 1 of Lender / Loan Type

Credit card 1 of Balance ($)

Credit card 1 of Limit ($)

Credit card 1 of Repayments Monthly ($)

Credit card 1 of Interest Rate (%pa)

Credit card 2

Credit card 2 of Lender / Loan Type

Credit card 2 of Balance ($)

Credit card 2 of Limit ($)

Credit card 2 of Repayments Monthly ($)

Credit card 2 of Interest Rate (%pa)

Store cards

Store cards of Lender / Loan Type

Store cards of Balance ($)

Store cards of Limit ($)

Store cards of Repayments Monthly ($)

Store cards of Interest Rate (%pa)

‘Buy now pay later ‘Plans

‘Buy now pay later ‘Plans of Lender / Loan Type

‘Buy now pay later ‘Plans of Balance ($)

‘Buy now pay later ‘Plans of Limit ($)

‘Buy now pay later ‘Plans of Repayments Monthly ($)

‘Buy now pay later ‘Plans of Interest Rate (%pa)

Personal loan 1

Personal loan 1 of of Lender / Loan Type

Personal loan 1 of of Balance ($)

Personal loan 1 of of Limit ($)

Personal loan 1 of of Repayments Monthly ($)

Personal loan 1 of of Interest Rate (%pa)

Personal loan 2

Personal loan 2 of Lender / Loan Type

Personal loan 2 of Balance ($)

Personal loan 2 of Limit ($)

Personal loan 2 of Repayments Monthly ($)

Personal loan 2 of Interest Rate (%pa)

Vehicle finance 1

Vehicle finance 1 of Lender / Loan Type

Vehicle finance 1 of Balance ($)

Vehicle finance 1 of Limit ($)

Vehicle finance 1 of Repayments Monthly ($)

Vehicle finance 1 of Interest Rate (%pa)

Vehicle finance 2

Vehicle finance 2 of Lender / Loan Type

Vehicle finance 2 of Balance ($)

Vehicle finance 2 of Limit ($)

Vehicle finance 2 of Repayments Monthly ($)

Vehicle finance 2 of Interest Rate (%pa)

HECS / HELP

HECS / HELP of Lender / Loan Type

HECS / HELP of Balance ($)

HECS / HELP of Limit ($)

HECS / HELP of Repayments Monthly ($)

HECS / HELP of Interest Rate (%pa)

ATO repayment plan

ATO repayment plan of Lender / Loan Type

ATO repayment plan of Balance ($)

ATO repayment plan of Limit ($)

ATO repayment plan of Repayments Monthly ($)

ATO repayment plan of Interest Rate (%pa)

Family loans

Family loans of Lender / Loan Type

Family loans of Balance ($)

Family loans of Limit ($)

Family loans of Repayments Monthly ($)

Family loans of Interest Rate (%pa)

Other (specify)

Other (specify) of Lender / Loan Type

Other (specify) of Balance ($)

Other (specify) of Limit ($)

Other (specify) of Repayments Monthly ($)

Other (specify) of Interest Rate (%pa)

TOTAL LIABILITIES

TOTAL LIABILITIES of Balance ($)

CURRENT LIABILITIES

Remaining Term (yrs)

To be cleared

Mortgage - Primary residence

Mortgage - Primary residence of Remaining Term (yrs)

To be cleared choices

Yes

Mortgage - Other home

Mortgage - Other home of Remaining Term (yrs)

To be cleared choices

Yes

Mortgage - Investment property 1

Mortgage - Investment property 1 of Remaining Term (yrs)

To be cleared choices

Yes

Mortgage - Investment property 2

Mortgage - Investment property 2 of Remaining Term (yrs)

To be cleared choices

Yes

Mortgage - Investment property 3

Mortgage - Investment property 3 of Remaining Term (yrs)

To be cleared choices

Yes

Margin loan

Margin loan of Remaining Term (yrs)

To be cleared choices

Yes

Credit card 1

Credit card 1 of Remaining Term (yrs)

To be cleared choices

Yes

Credit card 2

Credit card 2 of Remaining Term (yrs)

To be cleared choices

Yes

Store cards

Store cards of Remaining Term (yrs)

To be cleared choices

Yes

‘Buy now pay later ‘Plans

‘Buy now pay later ‘Plans of Remaining Term (yrs)

To be cleared choices

Yes

Personal loan 1

Personal loan 1 of Remaining Term (yrs)

To be cleared choices

Yes

Personal loan 2

Personal loan 2 of Remaining Term (yrs)

To be cleared choices

Yes

Vehicle finance 1

Vehicle finance 1 of Remaining Term (yrs)

To be cleared choices

Yes

Vehicle finance 2

Vehicle finance 2 of Remaining Term (yrs)

To be cleared choices

Yes

HECS / HELP

HECS / HELP of Remaining Term (yrs)

To be cleared choices

Yes

ATO repayment plan

ATO repayment plan of Remaining Term (yrs)

To be cleared choices

Yes

Family loans

Family loans of Remaining Term (yrs)

To be cleared choices

Yes

Other (specify)

Other (specify) of Remaining Term (yrs)

To be cleared choices

Yes

INSURANCE

Do you have adequate home and contents insurance?

Choices

Yes

In the event of a serious illness/accident that stops you from working for a prolonged period of time, how will you pay your mortgage (or rent if you were to sell the property), cover other liabilities and ongoing expenses?

Answer

In the eventof a terminal illness or accident resulting in death, how would your family maintain the lifestyle they are accustomed to now (for example pay the mortgage, pay for school fees, day to day living expenses)?

Answer

What stress would be placed on your family and/or personal relationships in the event you were struggling financially after a serious illness or accident?

Answer

Would you like to arrange a meeting to discuss options for your current and future insurance needs?

Answer

Yes

FINANCE NEEDS & OBJECTIVES

LOAN REQUIREMENTS & PURPOSE

What is the loan amount you wish to apply for?

Data

What is the intended occupancy of the property?

Choices

Owner occupied

Residential property

Both owner occupied and residential property

What is the purpose (or multiple purposes) for obtaining finance?

What is the loan term you wish to apply for?

years

months

How long do you expect to remain in this property?

years

months

CREDIT HISTORY

Applicant 1:

Have you ever had any financial judgments or legal proceedings recorded against you?

had any financial judgments or legal proceedings

Yes

If ‘yes’ please provide specific details:

Data

Are all of your current credit ‘finance’ commitments up to date?

Are all of your current credit ‘finance’

Yes

If ‘no’ please provide details on how you plan to bring your financial position and/or loan repayments in order/up to date:

Data

Applicant 2:

Have you ever had any financial judgments or legal proceedings recorded against you?

had any financial judgments or legal proceedings

Yes

If ‘yes’ please provide specific details:

Data

Are all of your current credit ‘finance’ commitments up to date?

Are all of your current credit ‘finance’

Yes

If ‘no’ please provide details on how you plan to bring your financial position and/or loan repayments in order/up to date:

Data

RISK PROFILE

Applicant 1:

Are you concerned about rising interest rates? (On a scale of 1-10: 1 is not concerned / 10 is highly concerned)

Data

Would you consider taking a fixed rate (either all fixed, or a split loan with part fixed and part variable)?

Choices

Yes

How would you rate your current job security? (On a scale of 1-10: 1 is not secure / 10 is highly secure)

Data

Applicant 2:

Are you concerned about rising interest rates? (On a scale of 1-10: 1 is not concerned / 10 is highly concerned)

Data

Would you consider taking a fixed rate (either all fixed, or a split loan with part fixed and part variable)?

Choices

Yes

How would you rate your current job security? (On a scale of 1-10: 1 is not secure / 10 is highly secure)

Data

LENDER PREFERENCE

Do you have a preference for the type of lender that you would like to deal with?

Checkboxes

Are there particular lenders you would prefer to use?

Are there particular lenders you would prefer NOT to use?

Is access to a branch network important to you?

Choices

Yes - important

No -not important

Don't mind

LOAN FEATURES AND PREFERENCES

Understanding your requirements

This section asks you to confirm which loan features you are interested in.

Please choose from one of the answers to confirm your preference:

Fixed rate

Choices

Important

Not important

Maybe, would like to discuss

I don't know

Variable loan

Choices

Important

Not important

Maybe, would like to discuss

I don't know

Split loan - part fixed and part variable

Choices

Important

Not important

Maybe, would like to discuss

I don't know

Rate lock (note: a fee may be payable to the lender to lock in a fixed rate)

Choices

Important

Not important

Maybe, would like to discuss

I don't know

Offset account

Choices

Important

Not important

Maybe, would like to discuss

I don't know

Redraw

Choices

Important

Not important

Maybe, would like to discuss

I don't know

Line of credit

Choices

Important

Not important

Maybe, would like to discuss

I don't know

Principal and interest repayments

Choices

Important

Not important

Maybe, would like to discuss

I don't know

Interest only repayments

Choices

Important

Not important

Maybe, would like to discuss

I don't know

Interest in advance repayments

Choices

Important

Not important

Maybe, would like to discuss

I don't know

Are there any other loan features which are important to you?

Data

PRIORITY PREFERENCES

Understanding your priorities

So I can provide you with a choice of lenders and loan options which meet your requirements and preferences.

Please choose from one of the answers to confirm your priorities:

My / our top priority is: (select one)

My / our second priority is: (select one)

My / our third priority is: (select one)

ANTICIPATED CHANGES TO CURRENT CIRCUMSTANCES

Applicant 1:

Do you plan or anticipate changes (other than retirement) to your future financial circumstances that could ADVERSELY impact your ability to repay the loan?

Do you plan or anticipate changes

Yes

If you answered yes, what are the changes to your circumstances which you anticipate?

Data

If you answered yes, how do you intend to make the loan repayments during this period of change?

Data

At what age are you planning to retire?

Data

If you have selected a term i.e. 25 years but you expect to retire in 15 years, please specify how you will continue to make loan repayments or have paid out the loan before you retire (what is your retirement plan)?

Data

Applicant 2:

Do you plan or anticipate changes (other than retirement) to your future financial circumstances that could ADVERSELY impact your ability to repay the loan?

Do you plan to anticipate changes

Yes

If you answered yes, what are the changes to your circumstances which you anticipate?

Data

If you answered yes, how do you intend to make the loan repayments during this period of change?

Data

At what age are you planning to retire?

Data

CUSTOMER IDENTIFIED LIVING EXPENSES

Would you be willing to change your current lifestyle and discretionary spending, if it had an impact on the amount of money you could afford to borrow?

Choices

Yes

Possibly, I would need to think about itPossibly, I would need to think about it

Would you be willing to reduce or cancel any existing liabilities such as credit cards, if it had an impact on the amount of money you could afford to borrow?

Yes

Possibly, I would need to think about itPossibly, I would need to think about it

I don’t have any existing liabilities

CLIENT DECLARATION

By signing below, I/we agree and acknowledge that:

I/we have received and carefully read the Credit Guide provided;
the information provided by me/us in this document is accurate and complete and is the basis on which credit assistance will be provided to me/us
if I/we have not provided full and/or accurate information, my broker will not be able to fully analyse my/our current financial situation, requirements and/or needs;
In providing credit assistance, my broker has not provided any financial, taxation or legal advice or made any enquiries about the appropriateness of any such advice that I/we may have received.

Name

Signature

Date

Applicant 1:

Signature

Clear

Date

Applicant 2:

Signature

Clear

Date

PRIVACY DISCLOSURE STATEMENT & CONSENT

In handling your personal information, DMEE HOLDINGS Pty Ltd, ABN 52 602 867 247 and its individual representatives are authorised credit representatives of InReach Finance Pty Ltd ACN 603 320 985 (Australian Credit Licence 469 248) Unit 22, 257 Balcatta Road Balcatta Western Australia 6021 Phone: (08) 6241 4895 is committed to complying with the Privacy Act 1988 and the Australian Privacy Principles.

How and why we collect your personal information - We collect personal information from you when you apply for or use our products and services, in particular the products and services you require. ‘Personal information’ may include any sensitive information (including health information) and may include any information you tell us about any vulnerability you may have.

Providing Your Personal Information to Other Organisations - In providing products and services to you it may be necessary for us to retain your personal information and provide it to other organisations with which we conduct business. We may exchange the information with the following types of entities, some of which may be located overseas:

Organisations which provide finance or other products to you or to whom an application has been made
Finance consultants, accountants and auditors, conveyancers, legal advisers, insurers and mailing services
Any associates, related entities, contractors and our mortgage aggregator (Connective)
Any industry body, tribunal, court or otherwise in connection with any complaint regarding our services
Any person where we are required by law to do so
Your referees, such as your employer, to verify information you have provided
Any person considering acquiring an interest in our business or assets
Any organisation providing online verification of your identity.

Your rights - You may gain access to the personal information that we hold about you by contacting us. You can also contact us to obtain a copy of our privacy policy. The policy contains information about how you can access or seek correction of the information we hold about you, how we manage that information and our complaints process.

If your personal information is not provided - If you do not provide us with all of the information we request we may be unable to supply to you the product or service that you require.

Consent to provide your personal information to a credit reporting body (CRB) - we can act as your agent to obtain a report or information about your consumer or commercial credit worthiness from a (CRB), we may disclose personal information such as your name, date of birth and address to the CRB to obtain an assessment of whether that personal information matches information held by it.

Checkboxes

Yes - I/we appoint

Data

of Permenant InReach Finance Pty Ltd to obtain a credit report on my/our behalf.

Applicant 1

Name:

Signature

Clear

Date:

Applicant 2

Name:

Signature

Clear

Date:

Your Broker's Name : Your Broker's Name :

If you are human, leave this field blank.

Personal Details

Applicant 1

Applicant 2

Employment Details

Applicant 1

Applicant 2

CURRENT-Primary

CURRENT-Secondary/Other

PREVIOUS - if within last two years

Net Income

Current ($)

Expenses

Current ($)

SELF EMPLOYED APPLICANTS (if applicable)

BUSINESS DETAILS & FINANCIAL POSITION

FINANCIAL POSITION - Assets & Liabilities

CURRENT STATUS

Description

Estimated Value ($)

Monthly Income ($)

Ownership

CURRENT LIABILITIES

Lender / Loan Type

Balance ($)

Limit ($)

Repayments Monthly ($)

Interest Rate (%pa)

CURRENT LIABILITIES

Remaining Term (yrs)

To be cleared

INSURANCE

FINANCE NEEDS & OBJECTIVES

LOAN REQUIREMENTS & PURPOSE

CREDIT HISTORY

RISK PROFILE

LENDER PREFERENCE

LOAN FEATURES AND PREFERENCES

Understanding your requirements

PRIORITY PREFERENCES

Understanding your priorities

ANTICIPATED CHANGES TO CURRENT CIRCUMSTANCES

CUSTOMER IDENTIFIED LIVING EXPENSES

CLIENT DECLARATION

Name

Signature

Date

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