Sample Application Form _final

Section 1 Customer Name Mr. & Mrs. Smith __________________

Loan Amount $ _ 920,000___________

Checklist B. Section A,G & H are for all applications, select as applicable from B, C, D, E, F, I,J & K A. 9 9 9 9 9 ‰

For all Applications Signed loan application 100 point ID documents for all applicants/ guarantor Estimate of Fees and Charges Form 112 or 119 Valuation fee $__300.00__ Loan Interview Record Sheet

D. 9

9

‰ ‰

2 current payslips and/or letter from your employer, confirming your salary, status (Full or Part Time, Casual, etc) and length of employment. Group Certificates (PAYG Summaries) for the last 2 years and/or Tax Returns for the last 2 years.

For Self Employed Last 2 years Tax Returns and Tax Assessment Notices– personal and business. PL A/C (Profit and Loss Account) and balance sheet for the last 2 years and tax assessment notices. Letter from Accountant certifying the accounts

F. ‰ ‰ ‰

For Company of Trust:

Assets and Liabilities verification Copies if rate notices or certificate of title for all properties owned showing DP number Statutory Declaration for gifted funds Credit card statements and loan account statements

I.

Property Purchase only

‰ Copy of last 6 months bank statements showing genuine savings pattern for 95% LVR ‰ Copy of bank statement showing available funds to complete the deal 9 Copy of exchanged Contract of Sale, dated, signed by the executed by both parties and witnessed ‰ First Home owners grant application,( if applicable) with directions to pay form

J. Refinance only 9 Last 6 months loan statements 9 Copy of Rates Notice 9 Refinance Discharge Authority Form 9 Copy of Current building insurance policy 9 Copy of previous sale contract to claim stamp duty exemption

Lo Doc

K. Construction Loan only ‰ ‰ ‰ ‰ ‰

Fixed Price building Contract signed by all parties Council approved & stamped building plan & specifications Builders’ registration certificate Builders’ all risks insurance policy Home owners warranty certificate

Declaration of financial position

H. ‰

Rental income: copy of lease and income statement Proposed rental income: Certificate from RE agent Certificate of interest earned & Dividend income

‰ ‰ ‰ ‰

Last 2 years Tax Returns, Assessment Notices, PL A/C and Balance Sheet. Last 2 years Tax Returns and Assessment Notices for all Directors or trustees and Guarantors. Trust Deed

G. ‰

C.

For Employed (PAYG)

E. ‰

‰ ‰ ‰

Other Income Documents

No Doc Declaration of financial position

Initials Applicant 1

Applicant 2

Page 1 to 7

Section 2 Breakdown of Loans

Split 1

Split 2

Split 3

Split 4

Loan Amount

Loan Amount

Loan Amount

Loan Amount

Home Construction (Owner Occupied)

**********

**********

**********

LOC (Line of Credit)

130,500

Purpose of Loan: Purchase Home (Owner Occupied)

389,500

Refinance Home (Owner Occupied)

400,000

Purchase Land / invest property Refinance investment property Construction investment property Sub Total

$ 389,500

Total (1+2+3+4) (should tally with section 1 & 4 Total)

$ 920,000

$ 130,500

$ 400,000

$

Section 3 Account Details Select Account type (Basic, Standard, Line

Optimiser

Equity Loan

Optimiser

Interest Rate

7.15%

7.25%

7.15%

Loan Type Option (Variable or Fixed)

Variable

Variable

Variable

If fixed, indicate term (1/3/5yrs)

N/A

N/A

N/A

Plan Option (6 or 12 months Discount rate)

N/A

N/A

N/A

Loan term (In year)

30

30

30

of Credit, Construction etc.)

Yes X

No

Yes X

No

Yes X

No

Yes X

No

Yes X

No

Yes X

No

Yes X

No

Yes X

No

Do you want additional Repayment?

Yes X

No

Yes X

No

Yes X

No

Yes X

No

Do you require Redraw facility?

Yes X

No

Yes X

No

Yes X

No

Yes X

No

Yes X

No

Yes X

No

Are payments to be interest only? If yes, indicate term (In months)? Do you require Debit card (If available)? Repayment Frequency (Weeky, fortnightly r Monthly (Specify Day or Date))

Any specific Lender preference?

Require Cheque book?

Section 4 Valuation Fee Payment Options

‰ By Cheque ‰ Deposited in Loanx

Bank Account

$

By Credit card : VISA/MC/AMEX

Number : ....256244551446532146.............. Expiry date : 02/09

In The Name Of

I authorise Loanx to debit my card with $ .....300.00............

...Mr. Vilson Smith...............................

Initials Applicant 1

Applicant 2

Page 2 to 7

Section 5 Personal Details

Applicant 1

Applicant 2

In what capacity are you applying?

X

Borrower

Are you the primary borrower?

X

Yes

Title (Ms / Mr / Mrs / Dr)

Mr.

Mrs.

First & Middle Name

Wilson

Amanda

Last Name

Smith

Smith

If you have ever changed your name, please state previous name?

No

No

Gender

X

Guarantor

X

Borrower

No

Male

Guarantor

Yes

No

X

Male

Female

Date of Birth

12/11/1964

16/08/1968

Driver’s Licence No

1362621

1362514

Marital Status

Married

Married

Spouse Name

Amanda Smith

Wilson Smith

No. of Dependents & Age

1 ( 17)

1 (17)

Home Phone No.

(02) 9258 5271

(02) 9258 5271

Work Phone No.

(02) 9200 9200

(02) 9600 9600

Mobile No.

0412 121 121

0400 121 000

Fax No.

(02) 92009211

(02) 9600 9611

Email

[email protected]

[email protected]

Residency Status

X

Citizen

Permanent Resident

X

Temporary Resident

Non-Resident

Female

Citizen

Permanent Resident

Non-Resident

Temporary Resident

Have you ever been Bankrupt or Credit defaulter?

Yes

X

No

Yes

X

No

Are you receiving unemployment benefits or worker compensation?

Yes

X

No

Yes

X

No

Have you applied for credit facility during the last 3 months

Yes

X

No

Yes

X

No

Section 6 Address Details Current Residential Address

Applicant 1

Applicant 2

24 SAMPLE ROAD, SYDNEY NSW -2000

Time at this Address

Years 12

Is this your mailing address

X

04 Months No

Yes

24 SAMPLE ROAD, SYDNEY NSW 2000 Years 12 X

Yes

If no, what is mailing address

N/A

N/A

If the current address is less than 3 years, state previous address

N/A

N/A

Post code

Suburb

Time at this address After settlement, will your residential address change

Years X

No

No

Post code

Suburb

Months

Yes

04 Months

Months

Years Yes

X

No

If yes, new mailing address Current Residential Status

X Owner Occupier Others……………………

Renting

Living with parents

If renting Name, Address & phone no. of Landlord or Real Estate Agent Initials Applicant 1

Page 3 to 7

Applicant 2

Initials Applicant 1

Applicant 2

Page 3 of 14

Section 7 Employment Details

Applicant 1

What is your Employment type?

Employment Status

X

Applicant 2

Salaried

Self Employed

X

Salaried

Self Employed

Social Benefits

Un Employed

Social Benefits

Un Employed

Student

Home Duties

Student

Home Duties

Retired

Retired

Full Time

Full Time

Occupation

Manager

Customer Service Officer

Name of Employer/Company

Mc Donald’s Family Restaurant

CBA

Address of Employer

121 Marsden street, Parramatta NSW 2150

365 George Street Sydney NSW 2000

Time at current Employment

____6__Years

___1___Years

No. of Employers in the last 2 years

1

2

Employer’s Payroll contact name

Mark Cox

Julie Jones

Employer’s Payroll phone no.

( 02

(

( FT/PT/Casual )

____0___Months

) 9256 2544

____2___Months

02 ) 9896 5590

If you have 2nd job, Name, Address & contact no. of Employer Employment Status & Occupation Date of joining the 2nd job If Self Employed, Trading name Business structure if Self Employed e.g. Sole trader, Partnership or Company Date Established & ABN / ACN

(___/___/____ )

(___/___/____ )

Section 8 Income Details Base Salary

Applicant1/Guarantor1/Director1

Applicant2/Guarantor2/Director2

85,000

65,000

$ 85,000

$ 65,000

Regular Overtime 2nd Job Income Investment Income Existing Rental Income Proposed Rental Income Other Income (e.g. commission/ Bonus) Car Allowance Total Income

Business/Company Income Description

Last Financial Year $

Previous Financial Year $

$

$

Net Profit before tax (Taxable Income) Add depreciation claimed Add interest paid Others

Total Income

Initials Applicant 1

Page 4 to 7

Applicant 2

Initials Applicant 1

Applicant 2

Page 4 of 14

Section 9 : Your Assets and Liabilities Assets To indicate the ownership of the property, please write in the

1 for Applicant 1; 2 for Applicant 2; 3 for Joint (1 & 2)

Address

Existing Property (Home)

3

Postcode

Value ($) 650,000

24 SAMPLE ROAD, SYDNEY NSW -2000

Monthly Investment Income ($)

Investment Property 1 Investment Property 2 Make

Motor Vehicle 1

Make

Motor Vehicle 2 Other Assets(e.g.

Model Toyota

Year Camry

2004

25,000

Year

Model

boat, tools of trade)

1. National Australia Bank

Savings with (Name of institution)

26,000

2. 3.

Deposit already paid on new home or investment property Superannuation

145,600

Shares Investments

97,000

Home Contents (Insured Value) Good will of Business XXXXX

Total Assets

943,600

XXXXX

Liabilities To indicate the ownership of the liability, please write in the

1 for Applicant 1; 2 for Applicant 2; 3 for Joint (1 & 2)

Facility Limit/Redraw ($)

Monthly Payments ($)

Financier

389,500

389,500

2,272

NAB

2,000

10,000

178

Virgin Money

Total Liabilities

391,500

399,500

2,450

Contingent Liability

Borrower?

Amount Owing ($)

Existing Mortgage 3

if debts to be Refinanced

X

(Home)

Existing Mortgage (Investment Property 1) Existing Mortgage (Investment Property 2) Personal Loans Or Hire Purchase Car Lease Other Details Store account/s, HECS, etc

Current rent/board Paid (if applicable)

Child Care/maintenance Credit Card Limits

x

(Indicate if paid In full for last three months)

Amount

Lender

$

(e.g. Guaranteed debt)

I

Initials Applicant 1 /

Applicant We confirm that we have disclosed all our credit cards2 and loans and no liability has been left out.

Initials Applicant 1

Applicant 2

Page 5 to 7 Page 5 of 14

Section 10 Security Details Security Address (No. & Street Name Suburb & Postcode)

Security Classification

Security 1

Security 2

24 SAMPLE ROAD, SYDNEY NSW – 2000

14 / 67-69 Try Road, Brisbane QLD 4000

X

Residential

X

Security Type

Commercial

House

Villa/Town House

Factory/Office

Vacant Land

X

Commercial

House

Rural

Factory/Office

If Unit, is it a part of complex consisting of more than 26 units or having more than 4

Residential

Unit

Villa/Town House

X

Vacant Land

Yes

X

No

Yes

X

No

If Unit, is floor size less than 50 sqm?

Yes

X

No

Yes

X

No

Is it a Serviced Apartment / Office

Yes

X

No

Yes

X

No

Unit Rural

storeys?

No. of Bedrooms

4 BEDROOMS

2 BEDROOMS

Land area (Approx)

890 SQM.

N/A

Value of Property

Purchase Price

$

Purchase Price

$ 500,000

Estimated Mkt. Val

$ 650,000

Estimated Mkt. Val

$

Occupancy

X

Own / Occupied

Is this your residential Address

X

Yes

No

X

Yes

No

Mortgage Priority

X

1st

2nd

X

1st

2nd

Ownership

X

Own

Purchase

X

Own

Purchase

Ownership in the Name(s) of

Mr. Wilson Smith & Mrs. Amanda Smith

Title type Title Details : Lot, DP & zone

X

Torrens Community

Own / Occupied

Investment

Strata

Company

Other ....................

X

Investment

Mr. Wilson Smith & Mrs. Amanda Smith Torrens

X

Community

Strata

Company

Other ....................

Lot 34 DP 2867

Lot 34 DP 2867

Section 11 Valuation Contact Details Contact Name to arrange Valuation

Security 1 Amanda Smith

Owners Agent (if Applicable) Day time contact Phone Nos.

Security 2 Mathew Bell Ray White Real Estate

(02) 9600 9600

Mobile 0400 121 000

(04) 9621 2622

Mobile 0411 163 961

Section 12 Solicitor / Conveyancer’s Details Are you acting on your own behalf?

Yes

No

If No. Name the law firm acting for you?

Associated Legal Services

Law Firm’s mailing Address

PO Box 561 Parramatta NSW 2150

Contact Name

Wayne Petines

Contact Phone No.

Off: (02) 9891 6200

Fax : (02) 9891 6300

Mobile : 0412 512 513

Section 13 Accountant Details Firm Name & Contact Person Contact Phone No.

Initials Applicant 1

Tax Accountants (David Hoang) Off : (02) 9626 2632

Applicant 2

Fax : (02) 96268899

Mobile : 0415 214 651

Page 6 to 7

Section 18 Verification Of Borrower – 100 Point Check List (AS REQUIRED BY THE FINANCIAL TRANSACTIONS REPORT ACT 1988) (Please write the points scored against each document selecting one out of each category)

Applicant 1 Full name of Applicant (surname, first)

Applicant 2

Smith Wilson

Points

Smith Amanda

Formerly known as (surname first

70

Passport, Birth or Citizen Certificate Name of the Issuing Body & Place of Issue

Immigration Dept ( Sydney)

Immigration Dept ( Sydney)

Account/Document No. & Place of Issue

L562544

L679236

Date of Birth

(12/ 11/1964)

(16/08/1968)

Issue & Expiry Dates

(____/___/____)

(__/___/____)

(___/___/___)

(___/___/____)

Drivers Licence, Pension concession card or Health care card or Student photo ID card (issued by

40

an Australian Tertiary Education Institution) Name of the Issuing Body & Place of Issue

RTA

RTA

Account/Document No. & Place of Issue

1362621

1362514

Date of Birth

(12/ 11/1964)

(16/08/1968)

Issue & Expiry Dates

(17/02/2001)

(17/02/2006)

(05/07/2004)

(05/07/2009)

35

Name/address confirmed by current/previous employer (within last 2 years) Name of the Issuing Body & Place of Issue

Account/Document No. & Place of Issue Date of Birth

(__/___/____)

Issue & Expiry Dates

(____/___/____)

(__/___/____) (__/___/____)

(___/___/___)

(___/___/____)

Financial Institution passbook, debit or credit card (1 per institution only) OR Medicare card OR Public utilities

25

record (1 only) Name of the Issuing Body & Place of Issue

Account/Document No. & Place of Issue Date of Birth

(__/___/____)

Issue & Expiry Dates

(____/___/____)

Total points Scored

110

(__/___/____) (__/___/____)

(___/___/___)

(___/___/____)

110

Result of the check Has verification been achieved

X

Yes

No

X

Yes

No

I confirm & declare that I •

Sighted original documents identifying the customer;

•

Have attached true copies of these documents to identification form;

•

Know that the documents to the best of my knowledge, relate to the person being identified.

* = Only 1 allowed

100 Point check must include at least one document with photo identification. Original documents MUST be sighted and a copy of the documents must accompany this form. I am satisfied that the individual who signs this is the person I identified using the form. Introducer’s Signature: __________________________

Date Completed:___20/09/06______________

I confirm that the identification is true identification of__Wilson Smith____ Signature of Applicant 1:____________________ (Complete Applicant Name)

I confirm that the identification is true identification of__Amanda Smith___ Signature of Applicant 2:____________________ (Complete Applican

Initials Applicant 1

Applicant 2

Page 7 to 7

Initials Applicant 1

Applicant 2

Page 8 to 7