Instructions: Please complete this form in full. All applicants must complete and sign. Use "N/A" where a question is not applicable. Ensure all supporting documents are attached.
Loan Purpose
Personal
Business
Vehicle
Home Improvement
Debt Consolidation
Education
Other (Specify):
Loan Amount Requested
Desired Loan Term (Months/Years)
Preferred Repayment Frequency
Weekly
Bi-weekly
Monthly
Quarterly
Application Type
Individual
Joint
Date of Application
Full Legal Name
First Name
Middle Name
Last Name
Date of Birth
Identification Type & Number
Residential Status
Own
Rent
With Family
Other:
Current Address
City
State/Province
Postal/ZipCode
Time at Address (Years and Months)
Previous Address (if less than 3 years at current)
City
State/Province
Postal/ZipCode
Primary Phone
Email Address
Full Legal Name
First Name
Middle Name
Last Name
Date of Birth
Identification Type & Number
Relationship to Primary Applicant
Primary Phone
Current Employment Status
Employed Full-Time
Employed Part-Time
Self-Employed
Retired
Other:
Occupation
Employer/Business Name
Employment Start Date
Gross Annual Income/Salary
Other Regular Income (Source & Amount)
Income Source | Amount | ||
|---|---|---|---|
A | B | ||
1 | |||
2 | |||
3 | |||
4 | |||
5 |
Current Employment Status
Employed Full-Time
Employed Part-Time
Self-Employed
Retired
Other:
Occupation
Employer/Business Name
Employment Start Date
Gross Annual Income/Salary
Other Regular Income (Source & Amount)
Income Source | Amount | ||
|---|---|---|---|
A | B | ||
1 | |||
2 | |||
3 | |||
4 | |||
5 |
Income | Amount | ||
|---|---|---|---|
A | B | ||
1 | Salary/Wages | ||
2 | Investment Income | ||
3 | Other Income | ||
4 | Total Monthly Income | $0.00 |
Expense | Amount | ||
|---|---|---|---|
A | B | ||
1 | Rent/Mortgage | ||
2 | Utilities (Electric, Water, Gas) | ||
3 | Food & Groceries | ||
4 | Transport (Fuel, Public Transit) | ||
5 | Insurance Premiums | ||
6 | Other Loan/Credit Repayments | ||
7 | Other Regular Commitments | ||
8 | Total Monthly Expenses | $0.00 |
Asset | Amount | ||
|---|---|---|---|
A | B | ||
1 | Cash/Savings Accounts | ||
2 | Market Value of Primary Residence | ||
3 | Other Real Estate | ||
4 | Vehicles | ||
5 | Investments/Shares | ||
6 | Superannuation/Pension Fund | ||
7 | Other Major Assets | ||
8 | Total Assets | $0.00 |
Liability | Amount | ||
|---|---|---|---|
A | B | ||
1 | Mortgage on Primary Residence | ||
2 | Other Property Loans | ||
3 | Car Loans | ||
4 | Personal Loans | ||
5 | Card Debt | ||
6 | Other Debts | ||
7 | Total Liabilities | $0.00 |
Net Position (Total Assets minus Total Liabilities)
Do you currently have, or have you previously had, any of the following with any financial institution? Please list the institution name and credit limit/balance.
Debt Type | Institution Name | Credit Limit | Balance | ||
|---|---|---|---|---|---|
A | B | C | D | ||
1 | Mortgage | ||||
2 | Card(s) | ||||
3 | Personal Loan(s) | ||||
4 | Overdraft Facility |
Are you currently a party to any legal proceedings?
Have you ever defaulted on a loan or declared bankruptcy?
Do you have any dependents not listed above?
Will this loan be secured against any asset (e.g., vehicle, property)?
If Yes, please describe.
Do you understand that a credit check may be performed as part of this application?
Please attach copies of the following documents where applicable.
Document Name | Upload File | ||
|---|---|---|---|
A | B | ||
1 | Proof of Identity (e.g., Passport, Driver's License) | ||
2 | Proof of Address (e.g., Utility Bill, Lease Agreement) | ||
3 | Proof of Income (e.g., Recent Pay Slips, Tax Returns, Bank Statements) | ||
4 | Proof of Assets (e.g., Property Valuation, Bank Statements, Vehicle Registration) | ||
5 | Proof of Existing Liabilities (e.g., Loan Statements) |
Important: By signing below, I/we:
Confirm that the information provided is true, accurate, and complete.
Authorize the Lender to verify the information provided, including conducting credit checks with credit reporting bodies.
Understand that providing false information may result in the application being declined or the loan being recalled.
Acknowledge that this is an application only and does not constitute a loan offer.
Consent to the collection and use of personal information for the purpose of assessing this application.
Primary Applicant Signature
Joint Applicant Signature
Application Received
Application ID
Assessed By
Status
Pending
Approved
Declined
Additional Info Required
Notes:
Form Template Insights
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This analysis breaks down the template's structure, intent, and practical utility for a form creator. It focuses on operational logic, user experience, and data integrity.
The form follows a deliberate progressive disclosure and narrative logic:
This order mirrors a logical assessment process, making it intuitive for both the applicant to complete and the reviewer to analyze.
Certain fields are not isolated; their value is in their relationship to others:
This template is built not just to collect data, but to tell a financial story. A well-completed form should allow a reviewer to construct a coherent narrative about the applicant:
Mandatory Questions Recommendation
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