Your Contact Details
Email Address:*
Title:*
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Dr.
Mr.
Mrs.
Ms.
First Name:*
Family Name:*
Street Address:*
City/Suburb:*
State:*
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Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
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Home Telephone:*
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Work Telephone:
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Mobile:
About Your Current Mortgage
Do you currently have a mortgage?
Yes
No
How long have you had your mortgage?
Please select...
Less than 1 year
1 - 2 years
3 - 5 years
6 - 10 years
More than 10 years
Which lender is your mortgage with?
Please select...
Access Home Loans
Adelaide Bank
AMP Banking
ANZ Bank
Aussie Home Loans
AXA Home Loans
Bank of Melbourne
Bank of Queensland
Bank of South Australia
BankWest
Bendigo Bank
Challenge Bank
Citibank
Colonial State Bank
Commonwealth Bank
CPS Credit Union (SA)
Credit Union Australia
Deutsche Bank
FAI Home Loans
Heritage Building Society
Home Building Society
Homeloans Limited
HomePath
HSBC
Illawarra Credit Union
ING Bank
Loancorp
Macquarie Bank
Melbourne Credit Union
National Australia Bank
NRMA Building Society
Police & Nurses Credit Union
Queensland Teachers Credit Union
RAMS Home Loans
RESI Mortgage Corporation
St George & Advance Bank
Statewest Credit Union
Statewide Home Loans
Suncorp Metway
Sydney Credit Union
United Credit Union
Westpac Banking Corporation
Wizard Mortgage Corporation
Other
If you have a mortgage, what is your monthly mortgage repayment?
About Your New Mortgage Needs
What is the purpose of the loan(s) you are seeking?
*
Please select...
Loan for my first home
Construction loan
Refinancing my current mortgage(s)
Investment loan
Reviewing my current mortgage(s)
Other
What is the amount you are looking to borrow?
What's the best time for a Mortgage Coach to contact you?*
Please select...
Anytime
Business hours
What is the current loan balance of your mortgage?
What is the approximate value of your property?
What is your combined household income per year?
Please select...
$0 - $20,000
$20,000 - $29,999
$30,000 - $39,999
$40,000 - $49,999
$50,000 - $59,999
$60,000 - $69,999
$70,000 - $79,999
$80,000 - $89,999
$90,000 - $99,999
$100,000 - $109,999
$110,000 - $119,999
$120,000+
How many times have you applied for mortgage finance in the past 6 months?
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None
Once
Twice
Three times or more
About Your Employment
What is your current employment status?*
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Employee
Self-employed
Retired
Unemployed
How long have you been in your current employment?*
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Less than 12 months
One to two years
Three to five years
More than 5 years
About Your Credit History
Have you had any credit problems in the last 4 years?*
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No
Yes
How would you rate your credit?*
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Perfect
Average
Not so good
Other Information
If you have additional notes that you feel will help your Mortgage
Coach to assist you, please enter thesein the space provided
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