Section 1

Customer Name Mr. & Mrs. Smith __________________ Loan Amount $ _ 920,000___________

Checklist
B. Other Income Documents
Section A,G & H are for all applications, select as
applicable from B, C, D, E, F, I,J & K
‰ Rental income: copy of lease and income statement
‰ Proposed rental income: Certificate from RE agent
A. For all Applications ‰ Certificate of interest earned & Dividend income

C. Assets and Liabilities verification

9 Signed loan application
9 100 point ID documents for all applicants/ guarantor
9 Estimate of Fees and Charges ‰ Copies if rate notices or certificate of title for all
9 Form 112 or 119 ‰ properties owned showing DP number
9 Valuation fee $__300.00__ ‰ Statutory Declaration for gifted funds
‰ Loan Interview Record Sheet ‰ Credit card statements and loan account statements

D. For Employed (PAYG) I. Property Purchase only

‰ Copy of last 6 months bank statements showing genuine

9 2 current payslips and/or letter from your employer,
savings pattern for 95% LVR
confirming your salary, status (Full or Part Time, Casual,
‰ Copy of bank statement showing available funds to
etc) and length of employment.
complete the deal
9 Group Certificates (PAYG Summaries) for the last 2
9 Copy of exchanged Contract of Sale, dated, signed by the
years and/or Tax Returns for the last 2 years.
executed by both parties and witnessed
‰ First Home owners grant application,( if applicable) with
E. For Self Employed directions to pay form

‰ Last 2 years Tax Returns and Tax Assessment Notices– J. Refinance only
personal and business.
‰ PL A/C (Profit and Loss Account) and balance sheet for 9 Last 6 months loan statements
the last 2 years and tax assessment notices. 9 Copy of Rates Notice
‰ Letter from Accountant certifying the accounts 9 Refinance Discharge Authority Form
9 Copy of Current building insurance policy
F. For Company of Trust: 9 Copy of previous sale contract to claim stamp duty
exemption

‰ Last 2 years Tax Returns, Assessment Notices, PL A/C

and Balance Sheet. K. Construction Loan only
‰ Last 2 years Tax Returns and Assessment Notices for all
Directors or trustees and Guarantors. ‰ Fixed Price building Contract signed by all parties
‰ Trust Deed ‰ Council approved & stamped building plan & specifications
‰ Builders’ registration certificate
‰ Builders’ all risks insurance policy
G. Lo Doc ‰ Home owners warranty certificate

‰ Declaration of financial position

H. No Doc

‰ Declaration of financial position

Initials Applicant 1 Applicant 2 Page 1 to 7

Section 2
Breakdown of Loans Split 1 Split 2 Split 3 Split 4
Purpose of Loan: Loan Amount Loan Amount Loan Amount Loan Amount
Purchase Home (Owner Occupied)
Refinance Home (Owner Occupied) 389,500
Home Construction (Owner Occupied) ********** ********** **********
LOC (Line of Credit) 130,500
Purchase Land / invest property 400,000
Refinance investment property
Construction investment property
Sub Total $ 389,500 $ 130,500 $ 400,000 $
Total (1+2+3+4) (should tally with section 1 $ 920,000
& 4 Total)

Section 3
Account Details
Select Account type (Basic, Standard, Line
Optimiser Equity Loan Optimiser
of Credit, Construction etc.)
Interest Rate 7.15% 7.25% 7.15%
Loan Type Option (Variable or Fixed) Variable Variable Variable
If fixed, indicate term (1/3/5yrs) N/A N/A N/A
Plan Option (6 or 12 months Discount rate) N/A N/A N/A
Loan term (In year) 30 30 30
Are payments to be interest only? Yes X No Yes X No Yes X No Yes X No
If yes, indicate term (In months)?
Do you require Debit card (If available)? Yes X No Yes X No Yes X No Yes X No
Repayment Frequency (Weeky, fortnightly r
Monthly (Specify Day or Date))
Do you want additional Repayment? Yes X No Yes X No Yes X No Yes X No
Do you require Redraw facility? Yes X No Yes X No Yes X No Yes X No
Yes X No Require Cheque Yes X No
Any specific Lender preference?
book?

Section 4
Valuation Fee Payment Options
‰ By Cheque
Bank Account $
‰ Deposited in Loanx
By Credit card : VISA/MC/AMEX Number : ....256244551446532146.............. Expiry date : 02/09

In The Name Of I authorise Loanx to debit my card with $ .....300.00............

...Mr. Vilson Smith...............................

Initials Applicant 1 Applicant 2 Page 2 to 7

 Section 5
Personal Details Applicant 1 Applicant 2
In what capacity are you applying? X Borrower Guarantor X Borrower Guarantor

Are you the primary borrower? X Yes No Yes No

Title (Ms / Mr / Mrs / Dr) Mr. Mrs.

First & Middle Name Wilson Amanda

Last Name Smith Smith

If you have ever changed your name, No No

please state previous name?

Gender X Male Female Male X Female

Date of Birth 12/11/1964 16/08/1968

Driver’s Licence No 1362621 1362514

Marital Status Married Married

Spouse Name Amanda Smith Wilson Smith

No. of Dependents & Age 1 ( 17) 1 (17)

Home Phone No. (02) 9258 5271 (02) 9258 5271

Work Phone No. (02) 9200 9200 (02) 9600 9600

Mobile No. 0412 121 121 0400 121 000

Fax No. (02) 92009211 (02) 9600 9611

Email Wilson@yahoo.com.au Amanda@hotmail.com

Residency Status X Citizen Permanent Resident X Citizen Permanent Resident

Non-Resident Temporary Resident Non-Resident Temporary Resident

Have you ever been Bankrupt or Yes X No Yes X No

Credit defaulter?

Are you receiving unemployment Yes X No Yes X No

benefits or worker compensation?

Have you applied for credit facility Yes X No Yes X No

during the last 3 months

Section 6
Address Details Applicant 1 Applicant 2
Current Residential Address
24 SAMPLE ROAD, SYDNEY NSW -2000 24 SAMPLE ROAD, SYDNEY NSW -
2000

Time at this Address Years 12 04 Months Years 12 04 Months

Is this your mailing address X Yes No X Yes No

If no, what is mailing address N/A N/A

If the current address is less than 3 N/A N/A

years, state previous address

Suburb Post code Suburb Post code

Time at this address Years Months Years Months

After settlement, will your residential Yes X No Yes X No

address change
If yes, new mailing address

Current Residential Status X Owner Occupier Renting Living with parents

Others……………………

If renting Name, Address & phone no.

of Landlord or Real Estate Agent
Initials Applicant 1 Applicant 2 Page 3 to 7

Initials Applicant 1 Applicant 2 Page 3 of 14

 Section 7
Employment Details Applicant 1 Applicant 2
What is your Employment type? X Salaried Self Employed X Salaried Self Employed
Social Benefits Un Employed Social Benefits Un Employed
Student Retired Home Duties Student Retired Home Duties

Employment Status ( FT/PT/Casual ) Full Time Full Time

Occupation Manager Customer Service Officer

Name of Employer/Company Mc Donald’s Family Restaurant CBA

Address of Employer 121 Marsden street, Parramatta NSW 365 George Street Sydney NSW 2000
2150

Time at current Employment ____6__Years ____0___Months ___1___Years ____2___Months

No. of Employers in the last 2 years 1 2

Employer’s Payroll contact name Mark Cox Julie Jones

Employer’s Payroll phone no. ( 02 ) 9256 2544 ( 02 ) 9896 5590

If you have 2nd job, Name, Address

& contact no. of Employer

Employment Status & Occupation

Date of joining the 2nd job

If Self Employed, Trading name

Business structure if Self Employed

e.g. Sole trader, Partnership or
Company

Date Established & ABN / ACN (___/___/____ ) (___/___/____ )

Section 8
Income Details Applicant1/Guarantor1/Director1 Applicant2/Guarantor2/Director2
Base Salary 85,000 65,000

Regular Overtime

2nd Job Income

Investment Income

Existing Rental Income

Proposed Rental Income

Other Income (e.g.

commission/ Bonus)

Car Allowance

Total Income $ 85,000 $ 65,000

Business/Company Income
Description Last Financial Year Previous Financial Year $
$

Net Profit before tax (Taxable Income)

Add depreciation claimed
Add interest paid

Others

Total Income $ $

Initials Applicant 1 Applicant 2 Page 4 to 7

Initials Applicant 1 Applicant 2 Page 4 of 14

 Section 9 : Your Assets and Liabilities
Assets
To indicate the ownership of the property, please write in the 1 for Applicant 1; 2 for Applicant 2; 3 for Joint (1 & 2)

Address Postcode Value ($) Monthly

Investment
Existing Property (Home) 3 24 SAMPLE ROAD, SYDNEY NSW -2000 650,000
Income ($)

Investment Property 1

Investment Property 2
Make Model Year 25,000
Motor Vehicle 1 Toyota Camry 2004
Make Model Year
Motor Vehicle 2

Other Assets(e.g. boat, tools of trade)

1. National Australia Bank 26,000

Savings with (Name of institution) 2.

3.

Deposit already paid on new home or investment property

Superannuation 145,600

Shares
Investments
Home Contents (Insured Value) 97,000

Good will of Business

Total Assets XXXXX 943,600 XXXXX

Liabilities
To indicate the ownership of the liability, please write in the 1 for Applicant 1; 2 for Applicant 2; 3 for Joint (1 & 2)

Amount Facility Monthly Financier if debts

Limit/Redraw Payments to be Re-
Owing ($)
($) ($) financed

Existing Mortgage 3 389,500 389,500 2,272 NAB X

(Home)

Existing Mortgage
(Investment Property 1)

Existing Mortgage
(Investment Property 2)

Personal Loans
Or Hire Purchase

Car Lease

Other Details
Store account/s, HECS, etc

Current rent/board Paid

(if applicable)

Child
Care/maintenance

Credit Card Limits 2,000 10,000 178 Virgin Money x

(Indicate if paid

In full for last

three months)

Total Liabilities 391,500 399,500 2,450

Contingent Liability Borrower? Lender Amount

(e.g. Guaranteed debt) $

I
Initials Applicant 1 / Applicant
We confirm that we have disclosed all our credit cards2 and loans and no liability has been left out. Page 5 to 7

Initials Applicant 1 Applicant 2 Page 5 of 14

Section 10
Security Details Security 1 Security 2
Security Address
24 SAMPLE ROAD, SYDNEY NSW – 2000 14 / 67-69 Try Road, Brisbane QLD 4000
(No. & Street Name Suburb & Postcode)

Security Classification X Residential Commercial X Residential Commercial

X House Villa/Town House Unit House Villa/Town House X Unit

Security Type
Factory/Office Vacant Land Rural Factory/Office Vacant Land Rural

If Unit, is it a part of complex consisting of Yes X No

more than 26 units or having more than 4 Yes X No

storeys?
If Unit, is floor size less than 50 sqm? Yes X No Yes X No

Is it a Serviced Apartment / Office Yes X No Yes X No

No. of Bedrooms 4 BEDROOMS 2 BEDROOMS

Land area (Approx) 890 SQM. N/A

Purchase Price $ Purchase Price $ 500,000

Value of Property
Estimated Mkt. Val $ 650,000 Estimated Mkt. Val $

Occupancy X Own / Occupied Investment Own / Occupied X Investment

Is this your residential Address X Yes No X Yes No

Mortgage Priority X 1st 2nd X 1st 2nd

Ownership X Own Purchase X Own Purchase

Ownership in the Name(s) of Mr. Wilson Smith & Mrs. Amanda Smith Mr. Wilson Smith & Mrs. Amanda Smith

X Torrens Strata Company Torrens X Strata Company

Title type
Community Other .................... Community Other ....................

Title Details : Lot, DP & zone Lot 34 DP 2867 Lot 34 DP 2867

Section 11
Valuation Contact Details Security 1 Security 2
Contact Name to arrange Valuation Amanda Smith Mathew Bell

Owners Agent (if Applicable) Ray White Real Estate

Day time contact Phone Nos. (02) 9600 9600 Mobile 0400 121 000 (04) 9621 2622 Mobile 0411 163 961

Section 12
Solicitor / Conveyancer’s Details
Are you acting on your own behalf? Yes No

If No. Name the law firm acting for you? Associated Legal Services

Law Firm’s mailing Address PO Box 561 Parramatta NSW 2150

Contact Name Wayne Petines

Contact Phone No. Off: (02) 9891 6200 Fax : (02) 9891 6300 Mobile : 0412 512 513

Section 13
Accountant Details
Firm Name & Contact Person Tax Accountants (David Hoang)

Contact Phone No. Off : (02) 9626 2632 Fax : (02) 96268899 Mobile : 0415 214 651

Initials Applicant 1 Applicant 2 Page 6 to 7

 Section 18
Verification Of Borrower – 100 Point Check List
(AS REQUIRED BY THE FINANCIAL TRANSACTIONS REPORT ACT 1988)
(Please write the points scored against each document selecting one out of each category)

Applicant 1 Applicant 2 Points

Full name of Applicant (surname, first) Smith Wilson Smith Amanda

Formerly known as (surname first

Passport, Birth or Citizen Certificate 70

Name of the Issuing Body & Place of Issue Immigration Dept ( Sydney) Immigration Dept ( Sydney)

Account/Document No. & Place of Issue L562544 L679236

Date of Birth (12/ 11/1964) (16/08/1968)

Issue & Expiry Dates (____/___/____) (__/___/____) (___/___/___) (___/___/____)

Drivers Licence, Pension concession card or Health care card or Student photo ID card (issued by
an Australian Tertiary Education Institution) 40

Name of the Issuing Body & Place of Issue RTA RTA

Account/Document No. & Place of Issue 1362621 1362514

Date of Birth (12/ 11/1964) (16/08/1968)

Issue & Expiry Dates (17/02/2001) (17/02/2006) (05/07/2004) (05/07/2009)

Name/address confirmed by current/previous employer (within last 2 years) 35

Name of the Issuing Body & Place of Issue

Account/Document No. & Place of Issue

Date of Birth (__/___/____) (__/___/____)

Issue & Expiry Dates (____/___/____) (__/___/____) (___/___/___) (___/___/____)

Financial Institution passbook, debit or credit card (1 per institution only) OR Medicare card OR Public utilities
record (1 only) 25

Name of the Issuing Body & Place of Issue

Account/Document No. & Place of Issue

Date of Birth (__/___/____) (__/___/____)

Issue & Expiry Dates (____/___/____) (__/___/____) (___/___/___) (___/___/____)

Total points Scored 110 110

Result of the check

Has verification been achieved X Yes No X Yes No

I confirm & declare that I

• Sighted original documents identifying the customer;
• Have attached true copies of these documents to identification form;
• Know that the documents to the best of my knowledge, relate to the person being identified.
* = Only 1 allowed
100 Point check must include at least one document with photo identification. Original documents MUST be sighted and a
copy of the documents must accompany this form. I am satisfied that the individual who signs this is the person I
identified using the form.
Introducer’s Signature: __________________________ Date Completed:___20/09/06______________

I confirm that the identification is true identification of__Wilson Smith____ Signature of Applicant 1:____________________
(Complete Applicant Name)

I confirm that the identification is true identification of__Amanda Smith___ Signature of Applicant 2:____________________
(Complete Applican

Initials Applicant 1 Applicant 2 Page 7 to 7

Initials Applicant 1 Applicant 2 Page 8 to 7