UNION FIDELITY CAPITAL FUNDING PTY.LTD
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1 UNION FIDELITY CAPITAL FUNDING PTY.LTD ABN: BRISBANE: SYDNEY: MELBOURNE: (03) UFC APPLICATION FORM In confidence when completed Individual applicants personal details Names of individual borrowers, company directors, partners or trustees (where information for subsequent applicant(s) is the same as prior applicant, please write as above. APPLICANT 1 APPLICANT 2 Status Borrower Guarantor Borrower Guarantor Family name (please print) First names Age & date of DOB: / / Age: DOB: / / Age: birth Marital Status Dependants Number: Ages: Number: Ages: Driver s licence State: No: Exp: / / State: No: Exp: / / Phone (home) ( ) ( ) Phone (work) ( ) ( ) Phone (mobile) Fax ( ) ( ) address Residential address Years at present address Current residential status If renting, how much per week Previous address (if at present < 2 years) Years at previous address Postal address Permanent Australian Resident Relationship to Applicant 1 Owned Mortgaged Renting Living with parents Other: Owned Mortgaged Renting Living with parents Other: Yes No Yes No
2 Employment and Income Details APPLICANT 1 APPLICANT 2 Employment details Self-employed PAYG Self-employed PAYG If Self-Employed ACN: ACN: ABN: ABN: How long has ABN been years years active for Nature of business Occupation Trading name of business Trading/Registered address of business Phone no. of business ( ) ( ) Annual net profit before $ $ tax Annual personal wage or drawings from company $ $ Length of employment years years Previous employer (if current < 2 years) Previous employer phone number ( ) ( ) Length of previous years years employment Previous occupation If PAYG (Pay As You Go) Occupation Employer Employer s address Full-time Casual Part-time Contractor Full-time Casual Employer s phone no. ( ) ( ) Length of employment years years Base salary $ $ Bonuses/overtime $ $ Additional payments $ $ Previous employer (if < 2yrs) Occupation Length of previous employment Additional income Government Allowances years Current gross rental income Property: Rental Income $ Type: Weekly Income: $ Maintenance $ $ Other (please specify) $ $ Part-time Contractor years Current gross rental income Property: Rental Income $ Type: Weekly Income: $
3 Company Applicant APPLICANT 1 APPLICANT 2 Status Borrower Guarantor Borrower Guarantor Company name ACN ABN and how long active for Names of directors Names of shareholders and share held Name of Trust (if applicable) Names of beneficiaries of Trust Principal business activity Registered office ABN: Active for: years Phone ( ) ( ) Fax ( ) ( ) Date of incorporation Contact Details Solicitor Accountant (required if self-employed) Nearest relative not living with you (Not to be the same person for different applicants) Firm: Contact Name: Address: Pcode: Phone: ( ) Fax: ( ) Firm: Contact Name: Address: Pcode: Phone: ( ) Fax: ( ) Name: Address: Pcode: Phone: ( ) Relationship to Applicant 1: Name: Address: Pcode: Phone: ( ) Relationship to Applicant 1: Loan Details Preferred Loan Structure Loan Amount Loan term (years) Facility Type Product Required P&I IO Low Verification of Income Full Verification of Income Is the loan predominantly for business or investment purposes? Yes No
4 Loan Purpose Requirements Amount $ Source Amount $ Purchase price (if applicable) Savings Refinance (if applicable) Gift (specify source) Legal fees Vendor finance Stamp duty & government charges Proceeds from property sale Establishment fees Proposed loan Other requirements (give Other sources (give details) details) TOTAL FUNDS REQUIRED Surplus Total Funds Available Security Property/ies Details *If property is rural please see next page Property 1 address Registered proprietors Title details Value Purchase price (if purchasing): $ EMV (if refinancing): $ Description of property including improvements (i.e. 4 brm house, unit, office, retail shop etc) Land size Zoning of property Present mortgagee Lender: Amount owing: $ Access Valuer Name: Contact No: Use Current: Owner/occupied Tenanted Business use Vacant Other: On settlement: Owner/occupied Tenanted Business use Vacant Other: Property 2 address Registered proprietors Title details Value Purchase price (if purchasing): $ EMV (if refinancing): $ Description of property including improvements (i.e. 4 brm house, unit, office, retail shop etc) Land size Zoning of property Present mortgagee Lender: Amount owing: $ Access Valuer Name: Contact No: Use Current: Owner/occupied Tenanted Business use Vacant Other: On settlement: Owner/occupied Tenanted Business use Vacant Other: Attach additional pages if more than 2 properties are being offered as security
5 Rural Property Details Property name Property address Registered proprietor Present mortgagee Area (hectares) Location (geographical) Land type/classification (eg. Irrigated, arable, grazing etc) Soil type Water (including dams, bores, water licenses etc) Fencing Improvements (residence, stables, sheds, silos etc) Rainfall (mm/yr) Agricultural activity Livestock Carrying capacity Shire Annual rates Land tenure (eg. Freehold ACT lease etc) Zoning Land title reference PROPERTY 1 PROPERTY 2
6 Statement of Assets and Liabilities for: A separate Assets & Liabilities is required for each borrower/guarantor unless assets are jointly held. ASSETS Property address Value Lender Repayment Motor vehicles Make Model Year Cash at bank Overdraft Institution A/C No Company Limit LIABILITIES Value Debt owned by Term deposits Credit/Charge Cards Shares Type Limit Other investments Debtors Creditors Work in progress Superannuation Personal effects Other (give (insurance value) details) TOTAL Notes: TOTAL
7 Business Background Please provide background details on all business activities and applicants: Details surrounding this loan application:
8 Confirmation of Loan Details Declaration Applicant 1 Applicant 2 Do you currently, or have you in the past, had any arrears Yes No Yes No with the loan being refinanced or any other current loans? Have any defaults, court judgements or writs been lodged on Yes No Yes No your CRAA Report? (Please provide details below of these including how much the original debt was for and who it was with, the circumstances that led to the default/s and if they have been paid, and when they were paid). Have you ever been bankrupt or entered into an arrangement Yes No Yes No to pay our creditors? Are there any unsatisfied court judgements against you? Yes No Yes No (please provide full details below including who is/was the plaintiff, how much is/was being sought and whether it has been finalised, and who did the court find in favour of). Have you ever been a director or shareholder of any Yes No Yes No company to which a manager, receiver or liquidator has been appointed? Has a mortgagee ever sold your property to recover a debt Yes No Yes No owing by you? Has an application for the above loan been submitted by you or any other person to another lender? Yes No Yes No If you answered yes to any of these questions, please provide details below: Signatures We certify that the information provided in this application is true and accurate and discloses our current and correct financial position to the best of our knowledge. We hereby authorise Union Fidelity Capital Funding Pty Ltd to obtain financial and other information related to this application from the named referees. Signature(s) of applicants Date / / / / Supporting documentation please see attached checklist Brisbane Office info@unionfidelity.com.au Website: If you have any queries please contact one of our Relationship Managers: Ben, Nikki, Daniel, Brandon Union Fidelity Capital Funding Pty Ltd ACN: Queen Street BRISBANE QLD 4000 Phone: or Fax: Sydney Office info@unionfidelity.com.au Website: If you have any queries please contact one of our Relationship Managers: Victoria, Lisa, Andrew, Scott & Neeta Union Fidelity Capital Funding Pty Ltd ACN: Suite 717, 33 Bligh Street SYDNEY NSW 2000 Phone: or Fax: Melbourne Office info@unionfidelity.com.au Website: If you have any queries please contact one of our Relationship Managers: Ursula Union Fidelity Capital Funding Pty Ltd ACN: Level 7,190 Queen Street MELBOURNE VIC 3000 Phone: Fax:
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