Application Type: Individual Application Joint Application
First Name: Last Name:
Date of Birth:
Drivers Licence: Learner Restricted Full Driver's Licence
Marital Status: Single Married Widowed De Facto Divorced Separated No of dependents
Phone: Mobile:
Email:
Residence Type: Own Renting Boarding Living with Parents
Address: Suburb:
City: Time at Address
Prev Address: Previous Suburb:
Previous City
Occupation: Employer
Time at Job:
FirstName: LastName:
City:
Relationship:
Home & Section: Mortgages:
Furnishings: Bank O/D:
Bank: All HPs:
Car: All Loans:
Investments: Credit Cards:
Others: Store Cards:
TOTAL ASSETS: TOTAL LIABILITIES:
NET WORTH:
Applicant Net Wages (after tax): Mortgage/Rent Payments:
Join Applicant New Wages(after tax): HP/Credit accounts:
Other Income: Reates/Phone/ Power:
Insurance (including life):
Other Expenses (pls specify):
TOTAL INCOME TOTAL EXPENSES:
