New Client Questionnaire Form

  • - Select Branch Office -
  • Bhavesh Chaudhari / Halak Patel (Adelaide)
  • Nirali Paun (Perth)
  • Krupesh Patel (Brisbane)
  • Gurtinder Singh
- Select Branch Office -
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Your E-mail Address
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Number of. Applicant
  • - select a option -
  • 1
  • 2
  • 3
  • 4
- select a option -
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Name of Applicant
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  • - Known by any other name -
  • Yes
  • No
- Known by any other name -
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Previous Name
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  • - Gender -
  • Male
  • Female
  • Other
- Gender -
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Title
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- DOB -
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Mob No
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Email Address
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Passport No
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Attach copy of passport...
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Driver License No
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Attach copy of driving licence...
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  • - Visa Status -
  • Citizen
  • PR
  • Visa
- Visa Status -
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Visa Subclass No
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Attach copy of visa...
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Current Address
Address Line 1
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Address Line 2
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Suburb
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Postcode
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State
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Start Date of Current Address
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  • Have you lived for more than 3 years at your current place ?
  • Yes
  • No
Have you lived for more than 3 years at your current place ?
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Address Line 1
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Address Line 2
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Suburb
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Postcode
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State
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Start Date of Previous Address
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End Date of Previous Address
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Mailling Address
  • Mailling Address
  • Same As Current address
  • Different Address
Mailling Address
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Address Line 1
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Address Line 2
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Suburb
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Postcode
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State
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Post Settlement Address
  • - Post Settlement Address -
  • Same As Current Address
  • Same As Property Address
  • Different Address
- Post Settlement Address -
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Address Line 1
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Address Line 2
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Suburb
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Postcode
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State
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Number of Dependent (i.e. child,spouse)
  • - select a option -
  • 1
  • 2
  • 3
  • 4
- select a option -
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Dependent Name
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- Dependent DOB -
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Next Of Kin
KIN Name
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KIN Contact
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  • - Relationship -
  • Mother
  • Father
  • Daughter
  • Son
  • Sister
  • Aunt
  • Uncle
  • Niece
  • Nephew
  • Cousin
  • Grandmother
  • Grandfather
  • Other
- Relationship -
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Relationship Other
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Address Line 1
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Address Line 2
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Suburb
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Postcode
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State
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Employment
Employer Name
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  • - Status -
  • Current
  • Previous
- Status -
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  • - Priority -
  • Primary
  • Secondary
- Priority -
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  • - Type -
  • Salaried
  • SelfEmployed
  • Retired
  • Unemployed
- Type -
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Occupation
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  • - Basis -
  • Full Time
  • Part Time
  • Casual
  • Contract
- Basis -
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Employment Start Date
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Employment End Date
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Address Line 1
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Address Line 2
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Suburb
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Postcode
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State
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Employer ABN/CAN
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Attach last two pay slips...
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Assets
Type of Assets
  • - Type of Assets -
  • Property
  • Saving
  • Motor Vehicle
  • Superannuation
  • Home Contents
  • Motor Vehicle
  • Shares
- Type of Assets -
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  • - Property -
  • Owner Occupy
  • Investment
- Property -
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  • - Type Of Property -
  • House
  • Unit
  • Apartment
  • Vacant Land
  • Other
- Type Of Property -
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Mention The Type of Property
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Address Line 1
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Address Line 2
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Suburb
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Postcode
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State
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Property Value
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  • - Property Valuation -
  • Applicant Estimate
  • Certified Valuation
- Property Valuation -
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Investment Property
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Financial Institution Name
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Type of account
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Amount
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  • - Vehicle Type -
  • Car
  • Motorcycle
  • Boat
  • Other
- Vehicle Type -
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Other Vehicle
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Model and Year
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Current Value
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Super Fund Institution
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Amount
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Home Contents Type
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Home Contents Insured
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Shares Name
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Shares Value
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Shares Balance Sheet
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Use Plus ( + ) sing to add New Assets
Liabilities
Type of Liabilities
  • - Type of Liabilities -
  • Mortgage Loan
  • Credit Card
  • Personal Loan
  • Car Loan
  • Student Loan
  • SMSF Loan/Balance Sheet
  • Other
- Type of Liabilities -
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  • - Property Type -
  • Owner Occupy
  • Investment Property
- Property Type -
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Address Line 1
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Address Line 2
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Suburb
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Postcode
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State
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Financial Institution
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Balance
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Limit
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  • - Type -
  • Fixed
  • Variable
- Type -
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Expire on
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Interest Rate
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Reverting Rate
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Term
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Years Left
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Repayment
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Bank
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Limit
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Balance
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Bank
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Limit
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Balance
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Term Left
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Repayment
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Interest rate
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Institution
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Limit
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Balance
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Term Left
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Repayment
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Interest rate
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Details
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Balance
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Monthly Repayment
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Details
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Details
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Use Plus ( + ) sing to add New Liabilities
Living Expenses (Per Month)

Grocery

Grocery
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Utility Expenses (Gas ,Water & Electricity)

Utility Expenses (Gas ,Water & Electricity)
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Cigarettes and Alcohol

Cigarettes and Alcohol
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Entertainment

Entertainment
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Dine out/Takeaway

Dine out/Takeaway
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Personal Care

Personal Care
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Clothing, Shoes and Accessories

Clothing, Shoes and Accessories
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Holidays

Holidays
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General Insurance

General Insurance
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Phone and Internet

Phone and Internet
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Pay TV and Media Subscription

Pay TV and Media Subscription
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Public education

Public education
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Private Education

Private Education
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Childcare

Childcare
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Tertiary and Vocational Education

Tertiary and Vocational Education
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Gym or Any Sports membership

Gym or Any Sports membership
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Private Health Insurance

Private Health Insurance
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Doctor, Dentist, Pharmacy and glasses

Doctor, Dentist, Pharmacy and glasses
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Life, Trauma and Income Insurance

Life, Trauma and Income Insurance
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Vehicle Running Cost

Vehicle Running Cost
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Vehicle Maintenance

Vehicle Maintenance
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Fuel

Fuel
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Vehicle Insurance

Vehicle Insurance
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Public Transport, Taxi, Rideshare

Public Transport, Taxi, Rideshare
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Primary Residence Body Corp

Primary Residence Body Corp
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Secondary Residence Running Cost

Secondary Residence Running Cost
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Secondary Residence Body Corp

Secondary Residence Body Corp
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Investment Property Running Cost

Investment Property Running Cost
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Investment Property Body Corp

Investment Property Body Corp
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Child or Spousal maintenance

Child or Spousal maintenance
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Current rent Expense

Current rent Expense
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Ongoing Board Expense

Ongoing Board Expense
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Discretionary Expense

Discretionary Expense
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TOTAL

$0.00
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Regarding Loan
  • - Objective & Needs -
  • Preapproval
  • New Loan
  • Refinance
- Objective & Needs -
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  • - Rate -
  • Fixed
  • Split
- Rate -
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How many yrs?
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  • - Repayment -
  • Principal and Interest
  • Interest Only
  • Other
- Repayment -
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Other
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  • - Special Feature -
  • Redraw
  • Offset
- Special Feature -
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Submit
Your Full Name
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Your E-mail Address
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Your Phonenumber
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Tell us about your project
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Submit