Marital Status
Single
Married
Separated
Divorced
Single
Married
Separated
Divorced
Length of time at this address
Are you:
Renting
Purchasing
Boarding
Renting
Purchasing
Boarding
Monthly accommodation cost:
$
$
If at this address less than 3 years, provide previous address.
Length of time at that address
Were you
Renting
Purchasing
Boarding
Renting
Purchasing
Boarding
Employment Status
Fulltime
Pension
Casual
Part-time
Fulltime
Pension
Casual
Part-time
Length of time with employer
Previous Employment
(If at current employer less than 3 years please provide details of previous employer)
Employment Status
Fulltime
Pension
Casual
Part-time
Fulltime
Pension
Casual
Part-time
Length of time with employer
Assets - include home, investments, cont, vehicles, etc.
Description
Value
Liabilities - include personal loans, store cards, credit cards, etc.
Other income(overtime etc):
$
Have you ever had, or are there now judgements or legal proceedings against you?
Yes
No
If yes, please give details:
Details of the nearest relative not living with you:
Please give 2 personal references:
Reference 1
Reference 2
Details of Car to be purchased:
How did you find us?
Please Choose
TV
Radio
Newspaper
Internet Search
Word of Mouth
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