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Are you a Borrower or Introducer?

Broker/Introducer Details

Broker/Introducer information

First Name

Last Name

Company Name

Phone/Mobile

Email Address

Introducer Fee

Commission

Loan Details

Facility

Loan Amount

Loan Term

Months

Security Type

Loan Purpose

Proposed Exit Strategy

Borrower Details

Borrower information

Company Details

Company

ACN

Address

City

State

Zip Code

Number Of Directors

Director 1

First Name

Last Name

Residential Address

Address

City

State

Zip Code

Residential Address Owned/Leased

Date Of Birth

Email Address

Phone

Director 3

First Name

Last Name

Residential Address

Address

City

State

Zip Code

Residential Address Owned/Leased

Date Of Birth

Email Address

Phone

Director 2

First Name

Last Name

Residential Address

Address

City

State

Zip Code

Residential Address Owned/Leased

Date Of Birth

Email Address

Phone

Director 4

First Name

Last Name

Residential Address

Address

City

State

Zip Code

Residential Address Owned/Leased

Date Of Birth

Email Address

Phone

Borrower Details Continued

Borrower information continued

Trading Business Details

Trading Name

ABN

Owning Entity

Trading Address

Address

City

State

Zip Code

Borrower Details Continued

Borrower information continued

Individual Borrower Details

Applicant 1

Applicant 1 information

First Name

Last Name

Residential Address

Address

City

State

Zip Code

Country

Residential Address Owned/Leased

Date Of Birth

Email Address

Phone

Applicant 2

Applicant 2 information

First Name

Last Name

Residential Address

Address

City

State

Zip Code

Country

Residential Address Owned/Leased

Date Of Birth

Email Address

Phone

Security Details

Security information

Number Of Security Properties

Security Property 1

Security Address

Address

City

State

Zip Code

Current Names On Title

Property Type

Property Description

Estimated Value

Current 1st Mortgage

1st Mortgage Lender

Security Property 3

Security Address

Address

City

State

Zip Code

Current Names On Title

Property Type

Property Description

Estimated Value

Current 1st Mortgage

1st Mortgage Lender

Security Property 5

Security Address

Address

City

State

Zip Code

Current Names On Title

Property Type

Property Description

Estimated Value

Current 1st Mortgage

1st Mortgage Lender

Security Property 2

Security Address

Address

City

State

Zip Code

Current Names On Title

Property Type

Property Description

Estimated Value

Current 1st Mortgage

1st Mortgage Lender

Security Property 4

Security Address

Address

City

State

Zip Code

Current Names On Title

Property Type

Property Description

Estimated Value

Current 1st Mortgage

1st Mortgage Lender

Security Property 6

Security Address

Address

City

State

Zip Code

Current Names On Title

Property Type

Property Description

Estimated Value

Current 1st Mortgage

1st Mortgage Lender

Asset & Liabilities Details

Asset & liabilities information

Commercial/Residential Real Estate

Address

Description

Owning Entity

Total

Value

Total Value

Current Lender

Total

Current Loan

Total Liabilities

Other Assets

(Vehicles/Business & Personal, Plant, Machinery, Stock, Shares Etc.)

Description

Owning Entity

Total

Grand Total

Value

Total Value

Current Lender

Total

Grand Total

Current Loan

Total Liabilities