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Responsible Lending Questionnaire

Applicant 1

Applicant 2

Surname

Surname
Date of Birth

Given Names

Female

Status

Male

Date of Birth

Given Names

Female

Status

Work Phone

Work Phone

Home Phone

Home Phone

Mobile Number

Mobile Number

E-mail

E-mail

Age of dependant children

Age of dependant children

Current Address

Current Address

Suburb
Date moved in

Post Code

State

Suburb

Residential Status

Post Code

Previous Address

Suburb
Post Code

Date moved in

State
Date moved in

State

Suburb

Residential Status

Post Code

State
Date moved in

Current Employment

Occupation

Occupation
Date Started

Employer

Employment Status

Employment Status

Gross income

Gross income

Gross bonuses

Gross bonuses

Gross overtime

Gross overtime

Previous Employment

Previous Employment

Occupation

Occupation

Employer

Employer

Employment Status

Employment Status

Date Started

Residential Status

Previous Address

Current Employment

Employer

Male

Date Finished

Date Started

Residential Status

Date Started

Date Finished

Assets and Liabilities


Assets (what you own) Please print extra pages for additional properties etc
Asset Type

Description

Total Value

Monthly
income

Total Residential Properties

Percentage Owned
App1

App2

Joint

Type
O/O

Inv

Property 1
Property 2
Property 3
Total shares/managed funds
Investment 1
Investment 2
Total savings/transaction accounts
Account 1
Account 2
Total Superannuation Funds
Fund 1
Fund 2
Motor Vehicles and Other Assets (provide year, make and model)
Motor Vehicle 1
Motor Vehicle 2
Other Asset 1
Other Asset 2

Liabilities (what you owe)


Liability Type

Lender

Interest
Rate

Limit

Monthly
Payments

Mortgage Loans
Property 1
Property 2
Property 3
Credit Card/store cards
Card 1
Card 2
Card 3
Card 4
Personal/Car Loans
Loan 1
Loan 2
Loan 3
Line of credit/Overdrafts
Account 1
Account 2
Other Fixed Liabilities (Leasing, Taxation, HECS, Child Maintenance etc)
Current Rent
Other 1
Other 2

Balance

Percentage Owned
App 1

App 2

Joint

To cease

Loan and Features


What is the purpose of the credit?
How long do you expect to remain in the credit contract?

Over 10 years

5 to 10 years

Less than 5 years

What is your budgeted monthly payment for the loan?


Extra pay-

Dont care

Nice to have

Must have Phone banking

Dont care

Nice to have

Must have

Loan redraw

Dont care

Nice to have

Must have Branch Access

Dont care

Nice to have

Must have

Offset Account

Dont care

Nice to have

Must have Multiple Splits

Dont care

Nice to have

Must have

Portability

Dont care

Nice to have

Must have Cheque book

Dont care

Nice to have

Must have

Internet access

Dont care

Nice to have

Must have Switch products

Dont care

Nice to have

Must have

Is there a product type that interests you?

Packaged loan

What is your preferred loan repayment type?

Principal and interest

Do you have a preferred lender type?

Major Bank

Line of Credit

Fixed Rate

Interest Only

Mortgage Manager

Basic Variable

Unsure

Unsure

Regional Bank

Building Society

Unsure

Are there any lenders you dont want to deal with?


How would you rate your current job security? (the higher the number, the more secure you feel)
1

10

Are you concerned about rising interest rates? (the higher the number, the higher your concern)
1

Are all your current credit commitments up to date?

Yes

10

No

If NOplease provide details including how you intend


to bring payments back in line
Have you had any judgements, defaults or legal proceedings against you?

Yes

No

If YESplease provide detailed information


Do you anticipate that your INCOME will decrease in the next 6-12 months?

Yes

No

Yes

No

If YESplease provide detailed information


Do you anticipate that your EXPENSES will increase in the next 6-12 months?
If YESplease provide detailed information

Do you have adequate Home and Contents Insurance as well as Insurance to meet your loan
repayments should you not be able to work i.e mortgage protection or income protection
If you answered NO, would you like one of our associates to contact you regarding insurance?

Yes

No

Yes

No

I/we authorise Mates Rates Mortgage Brokers to use the information to determine a suitable lender and loan product. I/we confirm
that all information gathered in this questionnaire is confidential and subject to the Privacy Act. Essentially, any personally identifiable information provided by me/us will not be released to anyone outside Mates Rates Mortgage Brokers without my/our prior written consent.
I/we confirm the information in this questionnaire is true and correct to the best of my/our knowledge as per the date signed.

_____________________________________________
Applicant 1
Date

_____________________________________________
Application
Date
Applicant 22

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