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Business Name
Existing Referral Partner YES
NO
Contact Name
Contact Number
Email Address
Suburb / Town
Postcode
Type of Finance Required Home Loan - Refinance
Home Loan - Purchase
Home Loan - Construction
Residential Investment Loan
NRAS - Completed Property
NRAS - Off the plan
NRAS - Construction finance
Commercial Property Mortgage
Business Finance
Plant & Equipment / Leasing
Development Funding
Debtor Finance / Factoring
Other (Detail Below)
Amount of Finance
Security Type Residential Real Property
Commercial Real Property
Vacant Land
Chattel Mortgage
Cash Cover
Mortgage/Charge over Business
Other (Detail Below)
Security Address (if property)
Security Value / Price
Client Name/s
Client Contact Number
Client Email
Contact Instructions Contact Referrer First
Contact Client Directly
Client Net Asset Position (if known)
Borrower 1 Employment Type Casual
Part-Time
Full-Time
Self-Employed
Contractor
Other (Detail Below)
Borrower 1 Length of Employment Under 3 Months
3 - 6 Months
6 - 12 Months
1 - 2 Years
More than 2 Years
Borrower 1 Income Under $40K
$40K - $60K
$60K - $80K
$80K - $100K
$100K - $150K
More than $150K
Borrower 2 Employment Type Casual
Part-Time
Full-Time
Self-Employed
Contractor
Other (Detail Below)
Borrower 2 Length of Employment Under 3 Months
3 - 6 Months
6 - 12 Months
1 - 2 Years
More than 2 Years
Borrower 2 Income Under $40K
$40K - $60K
$60K - $80K
$80K - $100K
$100K - $150K
More than $150K
Cash at Bank / Deposit Amount
Comments / Additional Information
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Assistance with loan product selection, debt reduction, debt recycling, risk minimisation and wealth creation. Ongoing reviews and assistance.
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