Loan Application

Employment Status *	Company Name of Employer *	Employer Contact Number *
Length of Employment * Under 6 Months6-12 MonthsOver 12 Months
Your Occupation *	Industry Group *	Number of Dependents *
Do you receive Centrelink Benefits? * YesNo	Are you the household sole income earner? * YesNo
Your Take Home (Net) Pay Amount *	Paid *
When Was Your Most Recent Pay Date?
The day your pay appears in your bank account *	Month *	Year *
How many small credit contracts have you had in the last 90 days? *
In the last 90 days have you missed / delayed any payments under a small amount credit contract? *		If 'Yes' please provide details
How will you use your advanced funds? *		If 'Other' please provide details
Monthly Expenses
Rent / Mortgage *
Loan Repayments	Other Living Expenses	(Food, Transport, Utilities, Phone & Miscellaneous)
Bank Account (The bank account into which your income is paid)
Bank Account BSB *	Bank Account Number *	Name of Account Holder *

Street Address Line 1 *			Street Address Line 2
Suburb *	State *	Postcode *
Barcode

e.g. 17 Mile Street Lexton Vic 6430 OR (for units) 5/17 Mile Street Lexton Vic 6430

Getting a loan