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Client Information
Your Information
Part 2 - Your Employment
*
Indicates required field
Employment Type
*
Select One
PAYG
Self Employed
Family Business
Home Duties
Retired
Student
Other
Employment Status
*
Select One
Full Time
Part Time
Casual
Contractor
Temp
Unemployed
If Casual, average hours / week
*
Job Title / Occupation
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Industry
*
Select One
Advanced Clerical & Service Workers
Associate Professionals
Elementary Clerical Sales & Service Workers
Farmer, Fisherman, Miner, Quarryman
Intermediate Clerical Sales & Service Workers
Intermediate Production & Transport Workers
Labourers & Related Workers
Managers & Administrators
Professionals
Time in Role - Months
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Years
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On probation?
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Yes
No
Annual Gross Income
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Employer / Company Name
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Employer Contact Name
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First
Last
Contact Email
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Employer Address
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Line 1
Line 2
City
State
Zip Code
Country
Contact Phone Number
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Time at this Employer (months, years)
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Date Employed From (dd/mm/yyyy)
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Additional income sources
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Overtime
Bonus
Allowance
Benefits
Other
Select any sources that apply
Source details:
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Your Assets
Complete any assets that apply
ASSET
ASSET VALUE
ASSET OWNER
Home - address
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$
*
Applicant 1, Applicant 2 or Both
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Investment 1 - Address
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$
*
Applicant 1, Applicant 2 or Both
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Investment 2 - Address
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$
*
Applicant 1, Applicant 2 or Both
*
Motor Vehicle 1 - Make, Model, Year
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$
*
Applicant 1, Applicant 2 or Both
*
Motor Vehicle 2 - Make, Model, Year
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$
*
Applicant 1, Applicant 2 or Both
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Investments
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eg. Shares/Manager Funds/Term Deposits
$
*
Applicant 1, Applicant 2 or Both
*
Savings Account 1 - Bank, BSB, Account No.
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$
*
Applicant 1, Applicant 2 or Both
*
Savings Account 2 - Bank, BSB, Account No.
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$
*
Applicant 1, Applicant 2 or Both
*
Home Contents - Insurer Name
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$
*
Applicant 1, Applicant 2 or Both
*
Other Assets
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e.g. boats, caravans, collections
$
*
Applicant 1, Applicant 2 or Both
*
Superannuation - Company
*
Superannuation - Company
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$
*
$
*
Other
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e.g. gifts, inheritance
$
*
Applicant 1, Applicant 2 or Both
*
Applicant 1, Applicant 2 or Both
*
Applicant 1, Applicant 2 or Both
*
Your Liabilities
Complete any liabilities that apply
Home Loan - Lender
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Investment Loan - Lender
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Investment Loan - Lender
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Car Finance - Lender
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Car Finance - Lender
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Personal Loan - Lender
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Credit Card - Lender
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Credit Card - Lender
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Credit Card - Lender
*
Monthly Repayment $
*
Monthly Repayment $
*
Monthly Repayment $
*
Monthly Repayment $
*
Monthly Repayment $
*
Monthly Repayment $
*
Monthly Repayment $
*
Monthly Repayment $
*
Monthly Repayment $
*
Balance $
*
Balance $
*
Balance $
*
Balance $
*
Balance $
*
Balance $
*
Balance $
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Balance $
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Balance $
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Total Loan Amt $
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Total Loan Amt $
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Total Loan Amt $
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Customer No.
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Customer No.
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Limit $
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Total loan amount when taken out
Limit $
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Limit $
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Limit $
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Int Rate %
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Interest Rate %
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Interest Rate %
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Interest Rate %
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Interest Rate %
*
Interest Rate %
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Interest Rate %
*
Interest Rate %
*
Interest Rate %
*
Loan Type - Select
*
Principal & Interest Variable
Principal & Interest Fixed
Interest Only Fixed
Interest Only Variable
Loan Type - Select
*
Principal & Interest - Variable
Principal & Interest - Fixed
Interest Only - Variable
Interest Only - Fixed
Loan Type - Select
*
Principal & Interest - Variable
Principal & Interest - Fixed
Interest Only - Variable
Interest Only - Fixed
Term Left (mm yy)
*
Term Left (mm yy)
*
Term Left (mm yy)
*
Customer No.
*
Customer No.
*
Customer No.
*
Store Card - Lender
*
Monthly Repayment $
*
Balance $
*
Limit $
*
Interest Rate %
*
Customer No.
*
Line of Credit (Used) - Lender
*
Balance $
*
Overdraft (Used) - Lender
*
Balance $
*
HECS / ATO Debt
*
Balance $
*
Monthly Repayment $
*
Other / Notes
*
Your Monthly Living Expenses
EXPENSE CURRENT MONTHLY AMOUNT FUTURE MONTHLY AMOUNT
(if buying consider council rates, water, insurance, etc)
BASIC HOUSING & PROPERTY EXPENSES
Power, Gas, Water,
Land/Council Rates, Strata Fees
$
*
$
*
COMMUNICATIONS & MEDIA
Internet/Home Phone,
Mobiles, Foxtel
$
*
$
*
FOOD & GROCERIES
Food, Eating Out
$
*
$
*
RECREATION & ENTERTAINMENT
Holidays, Movies, Newspapers Magazines
Gifts, General Entertainment, Foxtel, etc.
$
*
$
*
CLOTHING & PERSONAL CARE
Clothing, Personal Care, Grooming, etc.
$
*
$
*
MEDICAL & HEALTH
Medical, Doctor, Prescriptions
All Other Medical Costs
$
*
$
*
TRANSPORT
Rego, Fuel, Drivers Lic, Servicing,
Public Transport
$
*
$
*
EDUCATION & CHILDCARE
Fees, Books, Excursions, Sports, After
School Activities, Child Care, etc.
$
*
$
*
INSURANCE
Building, Contents, Life/Income,
Car/s, Health Ins
$
*
$
*
OTHER
Hobbies, Subscriptions, Memberships
$
*
$
*
RENT
Current rental payments
$
*
$
*
Your Credit History
Have there ever been or are there now any current Financial Judgements of Legal Proceedings against any of the applicants?
Select one:
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No
Yes
If yes, please provide details below
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Are you aware of any Current Defaults in the last 5 years on your personal Credit Report?
Select one:
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No
Yes
If yes, please provide details below
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Are you aware of any late payments on any liabilities such as Home Loans, Personal Loans (last 6 months) or Credit Cards (last 3 months)?
Select one:
*
No
Yes
If yes, please provide details below
*
And lastly, how did you hear about Citrus Finance?
.
*
Select one
Word of Mouth
Facebook
Met you!
Internet Search
LinkedIn
Saw your Marketing Material
Referred by Friend/Colleague
Other
Please ensure you have completed all the required fields
indicated by the
*
before clicking on the submission button below.
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