Short Form Application for a Private Loan

Financial capability

TELL US ABOUT YOUR BUSINESS

Business Name

Type of Business
CompanySole TraderPartnershipTrust

Registered Address

Suburb

State

Postcode

ACN/ABN/BN

Principal Activities

Business Phone

TELL US ABOUT THE DIRECTORS / GUARANTORS / BORROWERS / INDIVIDUAL APPLICANTS

Select Applicant Type

Given Names

Surname

Date of Birth

Drivers Licence

Registered Address

Suburb

State

Postcode

Home Phone

Mobile

Select Applicant Type

Given Names

Surname

Date of Birth

Drivers Licence

Registered Address

Suburb

State

Postcode

Home Phone

Mobile

WHAT IS THE PURPOSE OF THE LOAN?*

Amount Requested

When do you require the funds?

What is the purpose of the loan?

How long do you require these funds?

How will you repay the loan if approved?

Why is a bank or non-bank not available?

PLEASE TELL US WHICH OF OUR PRIVATE LOAN PRODUCTS YOU WISH TO APPLY FOR

Loan Product
1st Mortgage Business2nd Mortgage BusinessOther

SECURITY OFFERED

Security Offered

TELL US ABOUT YOUR PROPERTIES

	Street Address	Suburb	State	Postcode	Type	Ownership Details	Value $
1.
2.
3.
4.
5.

WHAT DO YOU OWE ON THESE PROPERTIES?

	Name of bank or non-bank 1st mortgage provider	Loan Amount $	Interest Rate %	Name of bank or non-bank 2nd mortgage provider	Loan Amount $	Interest Rate %
1.
2.
3.
4.
5.

BACKGROUND OF BORROWER

INTRODUCER / BROKER DETAILS

Name

Phone

Application

Short Form Application for a Private Loan

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