Customer Name * |
|
|
| Partners Name |
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Address |
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E-Mail * |
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Phone * |
Home |
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Work |
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Mobile |
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| DO YOU HAVE A CURRENT MORTGAGE: |
If so, who with
Owe How Much $
|
Term
years Int. rate
% Fixed / Variable
|
Scheduled repayment |
Frequency - weekly |
$
|
| |
Fortnightly |
$
|
| |
Monthly |
$
|
How much do you pay |
$
|
|
What would you estimate your current house to be worth on todays market |
$
|
|
| |
|
|
OTHER DEBTS:
Car Loans, Personal Loans, Credit Cards, Store Cards, etc. |
|
|
|
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| DEPENDANTS: |
|
|
Number
|
Approx.Ages
|
| |
|
|
| INCOMES: |
|
|
Applicant Salary $
|
Gross |
$
|
| |
Nett |
$
|
| |
|
|
Per: |
Week |
$
|
|
Fortnight |
$
|
|
Month |
$
|
|
Year |
$
|
| |
|
|
Partner Salary $
|
Gross |
$
|
| |
Nett |
$
|
| |
|
|
Per: |
Week |
$
|
| |
Fortnight |
$
|
| |
Month |
$
|
| |
Year |
$
|
| |
|
|
Other income (pension, family payment, super etc.)
|
| Type
|
|
|
| |
Gross |
$
|
| |
Nett |
$
|
| |
|
|
| |
Week |
$
|
| |
Fortnight |
$
|
| |
Month |
$
|
| |
Year |
$
|
| |
|
|
EXPENSES: |
|
|
Petty cash requirements for entertainment etc. $
per week
( Suggest $50 to $75 p.week) |
| |
|
|
Monthly living expenses $
Excluding Mortgage, Loans, etc. i.e. Living Expenses only.
(Suggest $800 per couple plus $200 per child, average about $1,200 per month) |
| |
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|
