Refinance Form

First Name *

Second Name

Last Name *

Street Number *

Street Address *

Suburb *

Postcode

State *

How long have you lived here

Years

Months

What weekly rent do you pay

Date of Birth *

Occupation *

Employer

Term of Employment

Years

Months

Gross Annual Income ($) *

Family Allowance etc. per fortnight($)

Do you have any other income?

YesNo

Marital Status

Number of Children

Telephone Home

Mobile

What is your finance refinance for?

Looking for Better Loan YesNo

Cash TakeoutYesNo

Business LoanYesNo

RenovationYesNo

What loan amount will you require?

Who is you current loan with? *

Is it Fixed or Variable? * FixedVariable

If you are buying an investment house, what weekly rental income do you expect to receive? Estimated Weekly Rental ($)

What is the address of the home you own or are refinancing?

Street Number *

Street Name *

Suburb *

State *

Postcode *

Please list known defaults below (If you do not know what is on your file then we can perform a check as your agent)

Amount ($)

Date Paid

Amount ($)

Date Paid

Please list all current loans

Lender (e.g. GE Finance etc.)	Amount Owing	Monthly Repayments

Please list all credit cards

Issued by (e.g. ANZ Visa)	Card Limit	Currently Owing

Your contact details

What is your Email Address?*

What is the best DAYTIME number to phone you on? *

What is the best time during the day to phone you? *

Any other comments of information that may help us