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Home Loan Health Check
Name(s)*
Email*
State
SA
NSW
VIC
QLD
WA
TAS
NT
Postcode
Best Daytime Contact Number*
If refinancing: Current Lender
Current Interest Rate (%pa)
Product Type
Basic Variable
Bridging
Construction
Debt Consolidation
First Home Owners
Fixed Rate
Fixed vs Variable
Honeymoon Rate
Interest Only
Line of Credit
LoDoc
Non-Conforming
Reverse Mortgage
Standard Variable
Purpose of Loan*
Loan Amount Required
Estimated Property Value
Gross Annual Income 1
Gross Annual Income 2
Annual Rental Income
Fortnightly Centrelink Income
First Home Buyer*
Yes
No
Number of Dependent(s)
Age of Dependents(s)
Savings Amount
Savings Period
Monthly Commitments
Personal Loan $
Car Loan $
Existing Home Loan $
Other Loans $
Credit Card Limits
Limits $
Balance $
Credit Rating*
(Please Select)
Good
Fair
Impaired
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