Form test – Wiz Loans Australia

INDIVIDUAL 1:

Please select

Please select
Mr
Mrs
Miss
Ms
Dr
Snr

Name Title

First Name*

Last Name*

Date of Birth*

Age(yrs)*

Mother's Maiden Name

Please select

Please select
Single
Married
Defacto
Widow
Other

Martial Status*

Email Address*

Please select

Please select
0
1
2
3
4
5
6+

No of Dependent Children*

Age

Work ph*

Mobile

Residential Address

Postcode

Years there

Home Phone

Fax

Previous Address

If less than 2 years at current

Post Code

Years There

Owned/buying

Owned/buying
Renting
Living with relative
Other

Current living arrangements

Australian Citizen

Australian Citizen
Resident
Non Resident
Are you a 1st home buyer?
Yes
No

Citizen

Postal address

Postcode

Driving Licence No

Expiry Date

INDIVIDUAL 2:

Please select

Please select
Mr
Mrs
Miss
Ms
Dr
Snr

Name Title

First Name*

Last Name*

Date of Birth*

Age(yrs)*

Mother's Maiden Name

Please select

Please select
Single
Married
Defacto
Widow
Other

Martial Status*

Email Address*

Please select

Please select
0
1
2
3
4
5
6+

No of Dependent Children*

Age

Work ph*

Mobile

Residential Address

Postcode

Years there

Home Phone

Fax

Previous Address

If less than 2 years at current

Post Code

Years There

Owned/buying

Owned/buying
Renting
Living with relative
Other

Current living arrangements

Australian Citizen

Australian Citizen
Resident
Non Resident
Are you a 1st home buyer?
Yes
No

Citizen

Postal address

Postcode

Driving Licence No

Expiry Date

EMPLOYMENT & INCOME

Occupation

Current Employment Status

PAYG

P/T

F/T

Casual

Self Employed

ABN#

GST Registered

Yes

Length of Employment

Years

Gross Annual Income

Net Annual Income

Other Income

Centerlink benefits

Funds Required

If Current Employment is Less Than 3 Years Provide Length of Previous Employment

Years

Defaults

Late Payments

EMPLOYMENT & INCOME

Occupation

Current Employment Status

PAYG

P/T

F/T

Casual

Self Employed

ABN#

GST Registered

Yes

Length of Employment

Years

Gross Annual Income

Net Annual Income

Other Income

Centerlink benefits

Funds Required

If Current Employment is Less Than 3 Years Provide Length of Previous Employment

Years

Defaults

Late Payments

INDIVIDUAL 1 EMPLOYER DETAILS:

Business Name of Employer

Postcode

Contact Name

Phone No

Full Address of Employer

Business Name of Previous Employer

Post Code

Contact Name

Phone No.

Full Address of Previous Employer

INDIVIDUAL 2 EMPLOYER DETAILS:

Business Name of Employer

Postcode

Contact Name

Phone No

Full Address of Employer

Business Name of Previous Employer

Post Code

Contact Name

Phone No.

Full Address of Previous Employer

Important Information

Please read our Wiz Loans Credit Guide. You will also receive this information in your email shortly. Please click here to read

Please read our Privacy Policy. You will also receive this information in your email shortly. Please click here to read

I have read and understood the Wiz Loans Credit Guide*

No Yes

I have read the privacy policy*

No Yes

Signature*

PERSONAL STATEMENT OF ASSETS AND LIABILITIES

Full Name(s):

Address:

Driver’s Licence Number(s):

ASSETS

Properties:

Address:

Value:

Vehicles:

Description (year, make, model):

Value:

Investments (shares, etc.):

Description:

Value:

Other Assets (savings, superannuation, furniture, etc.):

Description:

Bank

Value: