Client Information Form Client Information Form Please complete your information as accurately as possible. We will be in contact with you within one business day. Step 1 of 9 11% Number of applicants*Maximum 2Number of dependants*Enter 0 if no dependantsAges of dependants* Applicant 1* First Name Family Name Applicant 1-Email Address* Applicant 1 Mobile phone number*Applicant 2* First Name Family Name Applicant 2-Email Address* Applicant 2 Mobile phone number*Address* Street Address City Postcode Residential Status* Own home no mortgage Home with a mortgage Renting Living with parents Living with a friend Are you renting privately or through a real estate agent?* Real estate agent Privately Will you continue renting after your property purchase?* Yes No How much rent will you continue to pay each week?*How many years have you been at your current address?* Requirements and ObjectivesPurpose of Loan* First Home Buyer Buy a home (non first home buyer) Selling and buying again Keep property and buy again Buy an Investment property Refinance Home Loan Refinance investment loan Building a home( including buying land) Debt consolidation Divorce property settlement Reverse Mortgage Buy a vehicle Have you found a property to purchase?* Yes No Have you found a vehicle to purchase?* Yes No Estimated purchase price*How much do you want to borrow?*Deposit amount ( including money for purchase costs)*Deposit*Please tick the source of your depositSavingsEquity in other propertyGuarantorCash giftWhat type of property are your considering?* Existing property House and land Do you have a block of land?* Yes No Please enter the address of your land* Street Address City State / Province / Region ZIP / Postal Code Do you have building plans and specifications?* Yes No What is the value of your land?*How much is your loan on the land?*If you own outright, enter $0Please enter the suburbs where you might look for land* How much you do expect to pay for land?*How much do you expect to spend building your home?*How many bedrooms do you need?*Please enter a number from 1 to 6.Are you a first home buyer?* Yes No Employment and IncomeEstablishing your employment and income will help determine your borrowing capacityApplicant 1 age* 25-35 35-45 45-50 50-55 55-60 60-65 Over 65 Applicant 1 Employment Status* Permanent Full Time-35 hours/week or more Permanent Part Time-35 hours /week or less Casual Self Employed Contract Not currently employed Applicant 1-Occupation*Please enter your current occupation Applicant 1-How many years have you been with your current employer?*Pay Frequency*How often are you paid? Weekly Fortnightly Monthly Applicant 1-Gross Income per pay period*Your income before tax, excluding deductions and superannuation.Applicant 1-Do you have any pre Tax deductions?If yes, tick the relevant deduction(s). Novated Lease Payment Salary sacrifice-Superannuation Other Applicant 1 Novated Lease Pre tax Payments*How much do you pay (Pre Tax) for your Novated Lease each pay period?Applicant 1 Novated Lease After Tax Payments*How much is your after tax contribution each pay period?Applicant 1-Pre Tax Super Salary Sacrifice per pay period*Enter the total amount of pre tax suparannuation salary sacrifice per pay period.Applicant 1- Pre Tax Other Salary Sacrifice*Enter the amount of any other pre tax deductions per pay periodApplicant 1-Self Employed Business Structure* Sole Proprietor Partnership Company Applicant 1-How long have you been self employed?*Please enter the number of years of self employmentPlease enter a number from 1 to 40.Applicant 1 -Personal Gross Income per year*Applicant 1- Additional Superannuation ContributionsPlease include any additional Super payments to yourself above the 9.5% SGC.Applicant 1-DepreciationHow much do you claim for depreciation of assets?Applicant 1 -Interest on business loansApplicant 1-Business Profit (Companies only)Applicant 2 age* 25-35 35-45 45-50 50-55 55-60 60-65 Over 65 Applicant 2 Employment Status* Permanent Full Time-35 hours/week or more Permanent Part Time-35 hours/week or less Casual Self Employed Contract Not currently employed Applicant 2-Occupation*Please enter your current occupation Applicant 2-How many years have you been with your current employer?*Applicant 2-Pay Frequency*How often are you paid? Weekly Fortnightly Monthly Applicant 2-Gross Income per pay period*Your gross income before tax per pay periodApplicant 2-Do you have any pre Tax deductions?If yes, tick the relevant deduction(s). Novated Lease Payment Salary sacrifice-Superannuation Other Applicant 2 Novated Lease Pre Tax Payments*How much do you pay (Pre Tax) for your Novated Lease each pay period?Applicant 2 Novated Lease After Tax Payments*How much is your after tax contribution each pay period?Applicant 2-Pre Tax Super Salary Sacrifice*Enter the total amount of your pre tax superannuation salary sacrifice each pay periodApplicant 2-Pre Tax- Other Salary Sacrifice*Enter the amount of any other pre tax deductions pr pay periodApplicant 2-Self Employed Business Structure* Sole Proprietor Partnership Company Applicant 2-How long have you been self employed?*Please enter the number of years of self employmentPlease enter a number from 1 to 40.Applicant 2 -Personal Gross Income per year*Applicant 2- Additional Superannuation ContributionsPlease include any additional Super payments to yourself above the 9.5% SGC.Applicant 2-DepreciationHow much do you claim for depreciation of assets?Applicant 2 -Interest on business loansApplicant 2-Business Profit (Companies only) Other IncomePlease provide details on other sources of income as this will be helpful in completing your Assessment. Be as accurate as possible.Other sources of IncomeDo you receive income from any of the following sources (tick all that apply). Child Support Family Tax Benefit A and B Parenting Payment Carer's Allowance Child Support*How much do you receive in Child Support each month?Family Tax Benefit A and B per fortnight*What is your fortnightly Family Tax Benefit A and B? Do not include energy supplement or rental assistance.Parenting Payment*How much do you receive as Parenting Payment each fortnight?Carer's Allowance per fortnight*How much do you receive as Carer's Allowance each fortnight? ExpensesMonthly Household expenses*e.g. Food, school and club fees, eating out, car running costs, insurances, electricity and gas, council and water rates, phone, internet, alcohol, entertainment, pay TV etc.Child Support PaymentsHow much do you pay each month in Child Support to your ex partner? Enter 0 if none is paid. Your AssetsYour Family Home*What is the estimated market value of your family home?Home Loan*What is the current balance of your home loan? Enter $0 if no home loan.Home Loan Payments*How much are your home loan repayments per month?Home Loan bank or lender*Who is your home loan with? Cash Accounts*What is the total balance of all your current cash accounts?Shares & InvestmentEnter total value of shares and investments.Applicant 1-Superannuation*What is the current balance of all your Superannuation Funds?Applicant 2-Superannuation*What is the current balance of all your Superannuation Funds? Investment PropertiesHow many investment properties do you own?* None 1 2 More than 2 Investment Property 1 Value*What is the estimated market value of this property?Investment property loan 1*Enter current balanceInvestment property loan 1 repaymentsCurrent loan repayments per monthInvestment property loan 1Enter name of bank or lender Investment property 1 Rental Income*Enter current weekly gross rentInvestment Property 2 Value*What is the estimated market value of this property?Investment property loan 2*Enter current balanceInvestment property loan 2 repaymentsCurrent loan repayments per monthInvestment property loan 2Enter name of bank or lender Investment property 2 Rental Income*Enter current weekly gross rent Other LiabilitiesCredit Card Limits*Enter total limits on all of your credit cards. Enter 0 if you don't have a credit card.Credit Card Balances*Enter the total amount owing on all your credit cards. Enter 0 if there is nothing owing.ZipPay, AfterPay etc*Enter total limits on all of your ZipPay, AfterPay etc accounts. Enter 0 if you don't have any.ZipPay, AfterPay etc Balances*Enter the total amount owing on all your ZipPay, AfterPay etc accounts. Enter 0 if there is nothing owing.Personal / Car Loans Amounts*Enter the total amount owing on any Personal and/or Car Loans. Enter 0 if you don't have any loans.Personal / Car Loan Monthly Repayments*Enter the total monthly repayments on your Personal and/or Car Loans.HECS Debt*Enter current balance of your HECS debt. If you don't have a HECS debt, enter 0. Credit History and SummaryHave you ever had any credit defaults, judgements of ever been bankrupt?* Yes No In the past 12 months have any of your loan or credit payments been late?* Yes No Do you have any outstanding taxation debts?* Yes No Are you expecting any major changes to your financial situation in the near future that would reduce your ability to meet your loan repayments or reduce your income?* Yes No Credit History Notes*If you answered yes to any of the above credit history questions please provide explanations.SummaryIs there any other information we should know or is important to you?Privacy Disclosure Statement and ConsentHalogen Home Loans is collecting personal information about you. This notice is to inform you of your rights under the Privacy Act. 1. The personal and credit-related information you provide will be held by us. 2. You appoint us your agent to act as an ‘access seeker’ to obtain your credit-related information from a credit reporting body (CRB) on your behalf and for the purpose of assisting you with your application for credit. You authorise us to disclose any credit-related information we obtain to prospective financiers in connection with your application for credit. 3. We may use credit-related information and any other personal information you provide to arrange or provide credit and other services. 4. We may exchange the information with the following types of entities, some of which may be located overseas: • CRBs, including for a credit guarantee purpose; • persons who provide credit or other products to you, or to whom an application has been made for those products; • any person or entity who represents you including financial consultants, accountants, lawyers, mortgage brokers, persons holding power of attorney, guardians and advisers; • any industry body, government authority, tribunal, court or otherwise in connection with any complaint regarding our services; • any investors, agents or advisers, trustees, ratings agency or businesses assisting us with funding for credit made available to you or any entity that has an interest in your finance; • where we are authorised to do so by law, such as under the Anti-Money Laundering and Counter Terrorism Financing Act 2006 (Cth), government and law enforcement agencies or regulators; • any person where you have provided us consent; • any of our associates, related entities or contractors; • other guarantors or borrowers (if more than one) or borrowers or prospective borrowers of any credit you guarantee or propose to guarantee; • your referees, such as your employer, to verify information you have provided; • any person considering acquiring an interest in our business or assets; and • any organisation providing online verification of your identity 5. You may gain access to the personal information that we hold about you by contacting us. A copy of our privacy policy can be obtained by contacting us on 0410 520 398, email paul@halogenhomeloans.com.au or www.halogenhomeloans.com.au Our privacy policy contains information about how you may access or seek correction of the information we hold about you, how we manage that information and our complaints process. If you do not provide the information we may be unable to assist in arranging finance or providing other services. You agree that we may collect use and disclose your information as specified above By clicking the Request a Preliminary Assessment button, you agree that we may collect use and disclose your information as specified above By clicking the Request a Preliminary Loan Assessment button, you agree that we may collect use and disclose your information as specified above*By clicking the Request a Preliminary Loan Assessment button, you agree that we may collect use and disclose your information as specified above I agree