Applicant 1 Details
First name *
Last name *
Date of birth *   dd/mm/yyyy
Gender *

Male   Female

Marital status *
Current employment status *
Australian resident? * Yes   No
Australian driver's licence number
Dependant children
Home phone
Work phone
Mobile
Preferred contact method
Email *
Address *
Suburb *
State *      
Postcode *
How long have you been at this address?
Applicant 1 Employement
Occupation *
Employer *
Employer phone number *
Employed Since * dd/mm/yyyy  
Annual Income before tax * $ p.a
Previous Employment For yrs
Any other Income?
Applicant 2 / Guarantor Details
First name
Last name
Date of birth   dd/mm/yyyy
Gender

Male   Female

Marital status
Current employment status
Australian resident? Yes   No
Australian driver's licence number
Dependant children
Home phone
Work phone
Mobile
Preferred contact method
Email
Address
Suburb
State     
Postcode
How long have you been at this address?
Applicant 2 / Guarantor Employment
Occupation
Employer
Employer phone number
Employed Since dd/mm/yyyy  
Annual Income before tax $ p.a
Previous Employment For yrs
Any other Income?
Bank
Bank Name
Branch
Accountant
Firm
Address
Contact
Phone
Fax
Email
Personal References
Name: Address: Phone:
Credit References / History
Company Account Number Monthly Payout Current or Completed
Trade References
Company Contact Phone
Vehicle Details
New or Used: * New Used
Year *
Replacement or Additional * Replacement Additional
Make/Model *
KM's if used
Cost Price * $
Deposit / Trade * $
Supplier
Name
Address
Contact
Phone
Fax
Assets
House/Land at $
Car Make & year: $
Car Make & year: $
Accounts with Banks, Financial Institutions   $
Investments: (specify) $
Furniture, etc:   $
Superannuation   $
Other: (specify) $
Your Total Assests *   $
Liabilities
Owing on Home/Land $   Lender:
Personal Loan(s) $   Lender:
Credit Cards:  
1. Issuer   Limit: $
Current Balance: $
2. Issuer   Limit: $
Current Balance: $
Other:  
Lines of credit $
Store cards $
Taxation $
Your Total Liabilities * $