* Required Fields
First Name *
Last Name *
State QueenslandAustralian Capital TerritoryNew South WalesVictoriaSouth AustraliaWestern AustraliaTasmaniaNorthern Territory
How long have you lived at your current address?
What weekly rent do you pay?
Date of Birth
Start date of current employment
Gross Annual Income
No. of Children
Home Phone *
What is the price of your purchase?
Will you be occupying the house?
Yes, I will be occupyingNo, renting as investment
If you are buying an investment house, what weekly rental income do you expect to receive?
What is the Address of the house you are purchasing?
Do you have any savings?
Have you had a deposit?
Are you eligible for first home Grant?
Have you signed a contract to purchase?
Do you have any credit defaults?
Please list known defaults below
(If you're unsure, we can perform a check as your agent)
Please list all current loans
Lender (e.g. Westpac etc)
Please list all credit cards
Issuer (e.g, Westpac etc)
Your contact details
Email Address *
Daytime Phone *
Best time to call
Please add any additional comments that may help us *