Company Name:
Date of incorporation:		ACN:
Registered Address:
Postal Address:
City:		Postcode:
Principal Activity:
Name of Trust (if applicable):
Personal Particulars of Directors/Shareholders as Guarantors to be completed below.

To be completed by both Personal & Corporate Borrowers

Personal Particulars
Borrower 1		Borrower 2
Mr/Mrs/Ms:		Mr/Mrs/Ms:
Surname:		Surname:
Other Names:		Other Names:
Date of Birth:		Date of Birth:
Marital Status:		Marital Status:
Drivers Licence No:		Drivers Licence No:
Present Address:		Present Address:
Present City:		Present City:
Years There:		Years There:
Work Phone:		Work Phone:
Home Phone:		Home Phone:
Mobile:		Mobile:
Email:		Email:
Occupation:		Occupation:
Employer:		Employer:
Job Description:		Job Description:
Industry:		Industry:
Annual Salary Gross:		Annual Salary Gross:
Annual Salary Net:		Annual Salary Net:
Years Employed:		Years Employed:
Previously Employed by:  (if less than 3 years)		Previously Employed by:  (if less than 3 years)
Years There:		Years There:
Other Income
1:
2:

Security

Property Address:		Postcode:
Other (if applicable):		Postcode:
Purchase Price ($):
Estimated Value of Security  (if re-finance):
Is Property Let?:	Yes   No
Length of Lease:
Gross Rental ($ per annum):

Loan Details

Amount Required ($):		Term of Loan:
Purpose:	Home Purchase - Owner Occupied Home Purchase - Investment Refinancing Vehicle Purchase Plant & Equipment Business Other - Please specify:
Type of Loan:	Principal & Interest Interest only then converting to principal & interest

Statement of Assets and Liabilities

Note: every section of this Statement must be completed.
If a section is not applicable, write nil.

Assets		Liabilities
Particular	Value ($)	Lender		Monthly Payments ($)	Total Owing ($)
Existing Property/Home:		Existing Mortgage:
Address:
Other Property:		Existing Mortgage:
Address:
		Rent Paid (If Applicable):
Car/s:		Lease or Car Loan:
Furn/Household Effects:		Other Loans:
Other (give details):
Savings:		Personal Loans:
Bank:		Credit Cards:	Limit ($)
Bank:		Mastercard:
Building Society:		Visa:
Credit Union:		Other:
Other:		Store Card:
		Store Card:
		Store Card:
		Bank Overdraft:
Deposit paid on this  purchase (if applicable):		Taxation Liability:
Superannuation:		Child Support:
Other:
Total:		Total:

Contacts

Solicitor:	Firm:
	Address:
	Contact:
	Telephone:
Accountant:	Firm:
	Address:
	Contact:
	Telephone:
Closest relative not  living with you:	Name:
	Address:
	Telephone:

Declaration

I / we apply for an assessment and helpful suggestions on the loan detailed in this form which is to be secured by a first mortgage on the property described as security together with any additional security described as other security in this form. We confirm that all statements made in this form are true to the best of our belief and understanding.

It is agreed that Australian Lending Tree is to provide an appraisal at this stage only and that this is not a pre-approval.

I / we declare that at the time of signing this form the following answers are true and correct:

1. Have you ever been bankrupt or insolvent, has your estate ever been assigned for the benefit of creditors?
   Yes   No      If yes, please give details:
2. Have you or your spouse ever been shareholders or officers of any private company of which a manager, receiver and/or liquidator has been appointed?
   Yes   No      If yes, please give details:
3. Is there any unsatisfied judgement entered in any court against you, your spouse or any company of which you or your spouse are or were a shareholder or officer?
   Yes   No      If yes, please give details:
4. Have you or your spouse or any company of with which you are or were associated, ever had a property foreclosed upon?
   Yes   No      If yes, please give details:
5. Has any part of the deposit, or the balance due above this loan, been obtained through borrowing?
   Yes   No      If yes, please give details:
6. Has any application in respect of this loan been submitted by you, or any other person, to any other lender or broker?
   Yes   No      If yes, please give details: