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COPYRIGHT
COMMONWEALTH OF AUSTRALIA
Copyright Regulations 1969
WARNING
If Purchase If Re-Finance
YES/NO
Do you have an Accountant who is capable of assisting in this transaction?
CREDIT QUESTIONS
Applicant 1 Applicant 2
Have you been declared bankrupt or made arrangements with creditors?
Have you failed to keep up your payments on any credit cards, home loans etc?
Have you failed to maintain your bill payments – electricity, phone etc.?
Have you been charged or convicted of a criminal offence in the last 5 years?
APPLICANT DETAILS
Applicant one Applicant two
First Name/s
Surname
Date of Birth
Number & Age of Dependants
Relationship to other Applicant
Home Phone
Work Phone
Mobile
Email
Current Address
Current Residential Status
Time At Current Address (months)
Previous Residential Address
Previous Residential status
Time at that Residence
Mother’s Maiden Name
Nearest relative not living with you
(include name, address, phone,
relationship)
Employment status
Occupation
Time in current employment
Employer
Address of Employer
Phone number of Employer
Previous Employer Details (if current
employer < 3 years)
Occupation
Time in previous employment
Phone number of Previous Employer
Basic Salary (excludes super)
Extra (overtime/bonus/commission)
Other(pensions, rental, investment,
benefits, other)
PERSONAL OBJECTIVES
What are your financial goals/plans for
the next 12 months?
What are your financials goals/plans for
the next 5 years?
What are your financial goals/plans for
the next 10 years?
FINANCIAL POSITION
ASSETS
Item Description Income Value Owner
Savings account balance
Other account balances
Current Property 1
Current Property 2
Current Property 3
Motor Vehicle 1
Motor Vehicle 2
Home Contents
Shares / Investments
Super
Other
LIABILITIES
Balance
Item Lender detail Repayments Borrower
Owing
Rent (paid)
Home Loan 1
Home Loan 2
Home Loan 3
Motor Vehicle 1
Motor Vehicle 2
Other Loan 1
Other Loan 2
Credit Card 1
Credit Card 2
Credit Card 3
HOUSEHOLD EXPENDITURE
FIXED EXPENSES
Item Weekly Monthly Quarterly Annually
Insurance – Car, house etc.
Charitable Contributions
Childcare
Car – Registration, petrol etc.
Groceries
Utilities
Medical
Entertainment
Other –
Total
REPAYMENTS
Repayment cycle Weekly Fortnightly Monthly
Why is this repayment cycle
required/preferred?
Repayment type Principal & Interest Interest Only Interest in Advance
Why is this repayment type
required/preferred?
LOAN FEATURES
Feature Important Not important
Ability to make extra repayments
Offset Account
Ability to Redraw funds
Branch Network
Internet Banking
Bank Account/s with same institution
Other – please describe
Is there anything else that may reasonably be expected to have a bearing on your application for credit,
knowing that if you leave such information out it may create problems in the future? Please specify:
Are you comfortable with your ability to make repayments under the proposed loan without difficulty?
Please specify:
INSURANCE QUESTIONS
As part of the mortgage process The Selector Group will conduct a review on your current insurances.
I/We confirm that I/We are happy to have my/our insurance reviewed.
I/We confirm that I/We have been offered the opportunity to have my/our insurance reviewed however
I/We have declined to do this.
I/We understand that I/We may not have the appropriate cover should I/We suffer from an
unexpected/adverse event.
Do you smoke?
Are there any matters which could affect the Insurers decision to
accept an insurance risk policy?
Details:
Details:
LIFESTYLE QUESTIONS
Are you interested in exploring other investment strategies?
Tax minimisation is an essential part of a good financial plan.
Are you interested in exploring further?
Do you have a Will?
Are you confident that your dependents can maintain their standard of living should anything
happen to you?
If you were to become temporarily disabled tomorrow, are you confident that your existing cash
reserves are adequate to allow you to get back on track?
Will the retirement strategy you have in place deliver the retirement lifestyle you expect?
YOUR HOME IS AT RISK IF YOU DO NOT KEEP UP REPAYMENTS ON A MORTGAGE OR OTHER LOAN
SECURED UPON IT
I/We confirm that personal & confidential information provided by me/us can be disclosed by Mortgage
Selector to arrange a mortgage on my/our behalf and that I/we have read this document before signing.
The information contained in this document is true and correct.
I/We confirm I/We would like to receive ongoing email updates from The Selector Group Companies
I/We confirm I/We would like to receive updates & documentation via email e.g.: Product information,
Lender forms & approval
Signature of borrower 1
Signature of borrower 2
You agree that Originator Mortgages may collect and use your personal information as specified above.
Signature Signature
Date Date