Fields marked with • are required to be completed before the form can be submitted.

Personal and Contact Details

Name •

Postal Address (so that we can send you are hard copy of the report)

• Please make sure at least one of the contact numbers or addresses is provided.

Work phone

Home phone

Mobile phone

Contact email •

General Questions

How did you hear about Prosolution Private Clients?

Other/Additional info...

What is the purpose of your enquiry?

When will you need this finance?

How much do you want to borrow?

Property (Security) 1 details… (If you are planning on purchasing a property then note the details of your 'target' property.)

Property's estimated value
Property's location
Rental income (p/w)
For existing properties...
Existing mortgage amount?
Interest Rate Fixed/Variable? Fixed Variable
Lender

Property (Security) 2 details

Property's estimated value
Property's location
Rental income (p/w)
For existing properties...
Existing mortgage amount?
Interest Rate Fixed/Variable? Fixed Variable
Lender

Property (Security) 3 details…

Property's estimated value
Property's location
Rental income (p/w)
For existing properties...
Existing mortgage amount?
Interest Rate Fixed/Variable? Fixed Variable
Lender

More than 3 properties?

We need the details of all properties that you own. Therefore, if you own more than three properties please provide all the details. You can use this additional form that you can email to us.

Have the applicant/s had any credit problems/defaults in the past?

Income & Expense Information

Applicant 1 - What is your income, occupation and how long have you been in your current role?

Income Select frequency Gross p.a. Gross p/fortnight Gross p/week Net p.a. Net p/fortnight Net p/week
Select occupation Doctor - private Doctor - public Doctor - private & public Dentist (own private practice) Dentist (Commission only) Dentist (Employee) Dental hygienists Pharmacists Surgeon Accountant - Partner Acountant - Senior Mgr / Mgr Accounatnt - Staff Lawyer - Partner Lawyer - Senior Associate Lawyer - Associate Lawyer - Other Senior Executive (CEO, MD) Senior Manager (large corporate) Other (pease specify below)
Occupation - Other (please note)
Time in current position:
Years Months

Applicant 2 - What is your income, occupation and how long have you been in your current role?

Income Select frequency Gross p.a. Gross p/fortnight Gross p/week Net p.a. Net p/fortnight Net p/week
Select occupation Doctor - private Doctor - public Doctor - private & public Dentist (own private practice) Dentist (Commission only) Dentist (Employee) Dental hygienists Pharmacists Surgeon Accountant - Partner Acountant - Senior Mgr / Mgr Accounatnt - Staff Accountant - Other Lawyer - Partner Lawyer - Senior Associate Lawyer - Associate Lawyer - Other Senior Executive (CEO, MD) Senior Manager (large corporate) Other (pease specify below)
Occupation - Other (please note)
Time in current position:
Years Months

Other income (other than rental income mentioned above)

Are you a member of a professional association? (Some lenders offer members of professional associations special rates)

Other

Other financial commitments? (E.g. minimum loan repayments for loans that will not be consolidated, personal rental expense that will continue after the loan, personal loans)

Select... Yes, I have other financial commitments No, I dont't have any other financial commitments
per month Select.. Rental expense to continue Car Loan Investment Loan Personal Loan Child Maintenance Other
per month Select.. Rental expense to continue Car Loan Investment Loan Personal Loan Child Maintenance Other
per month Select.. Rental expense to continue Car Loan Investment Loan Personal Loan Child Maintenance Other

Number of dependants under the age of 18?

Total credit card limits (limits for all credit cards)?

Do you have adequate risk insurance?

Do you have income protection insurance?

Do you have life insurance?

When did you last review your insurance cover?

Deposit - Purchases Only

Do you qualify for the First Home Owners Grant? (Refer to http://www.firsthome.gov.au)

How much deposit do you have? Where has these saving come from?

Lender/Product References

Are there any lenders you don't want to deal with?

Details...

How would you like to repay the loan?

Would you like a fixed rate or variable?

If fixed or split please note term/details

Who do you currently use for the majority of your banking needs (please name financial institution/s)?

What is most important to you?

Most important : Select... Lowest overall cost (inc. rate & fees) Banking network (i.e. branches, ATMs) Line of credit Offset account Well known lender Other (please specify below)
Second Most important : Select... Lowest overall cost (inc. rate & fees) Banking network (i.e. branches, ATMs) Line of credit Offset account Well known lender Other (please specify below)
Third Most important : Select... Lowest overall cost (inc. rate & fees) Banking network (i.e. branches, ATMs) Line of credit Offset account Well known lender Other (please specify below)

If we are able to fulfil the important factors above, are there any reasons why you would not use our service? If so, what are your concerns?

Select No Yes, I have some concerns (please specify)
Details...

Have you contacted any other lenders or mortgage brokers?

Select No Yes (provide details - who & status)
Details...

Questions or Comments?

Any other questions or comments etc.