Alan May Group Fast finance enquiry form

Full Name*

Email*

Daytime phone

Mobile phone

Work phone

First Name

Middle Name

Surname

Date of Birth

Drivers Licence No.

Licence Expiry Date

Address

Town/Suburb

Postcode

Time at this address

Address

Town/Suburb

Postcode

Time at this address

Bank Mortgage Rental Property Own Property

Bank/Landlord

Location

Contact Number

Occupation

Business Name

Address

Town/Suburb

Postcode

Time at this employer

Previous Occupation

Business Name

Address

Town/Suburb

Postcode

Time at this employer

Income

Net or Gross Please Select Nett Gross

Per Please Select Week Fortnight Monthly Yearly

Other income - investments, rent or other

Source

Income

Net or Gross Please Select Nett Gross

Per Please Select Week Fortnight Monthly Yearly

Property Value

Amount Owing

Other Property Value

Amount Owing

House Contents Value

Investments Value

Cash & Savings Value

Other investments

Rent/Mortgage amount?

Per Please Select Week Fortnight Monthly Yearly

Do you have credit cards? Please Select Yes No

Lender

Limit

Repayments

Do you have other loans? Please Select Yes No

Lender

Loan Amount

Repayments

Please list any other expenses:

Have you been bankrupt? Please Select Yes No

Do you have any paid or unpaid defaults? Please Select Yes No

Do you have any court judgements? Please Select Yes No

If yes for above 3 questions, please give details:

Do you agree to a Veda CRA check? Please Select Yes No

Name

Address

Town/Suburb

Postcode

Accountants Details (if self employed):

Accountants Name

Phone Number