HOME LOAN APPLICATION FORM

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1 HOME LOAN APPLICATION FORM Member number/account type Broker details L L.. De / / Broker Contact Name Phone Fax Aggregor Group Name Heritage BDM Name Has applicion been processed electronically? Broker Disclosure I hereby confirm th all applicable requirements of Heritage Bank's lending guidelines have been sisfied for verificion of all savings, income and expenses, including formal identificion, by either face to face interview or identificion via Australia Post office according to FTRA and AML/CTF legislion requirements. Broker's signure Loan details - Loan 1 Applicion Fee Principal and interest Loan term Total Loan Amount Including fees and charges Interest only Line of Credit Bridging Loan Loan type Home Advantage Package Interest Variable Fixed Interest only 1 year 2 years 3 years 5 years Loan details - Loan 2 Applicion Fee Principal and interest Loan term Total Loan Amount Including fees and charges Interest only Line of Credit Bridging Loan Loan type Home Advantage Package Interest Variable Fixed Interest only 1 year 2 years 3 years 5 years Loan purpose 1) Wh is the purpose of this loan? Owner Occupied Investment To buy To build To refinance Bridging Loan House Home Unit Vacant Land Other (specify) House Improvements (to an existing house/home unit) Existing mortgage with Existing debts with Purchased from Vendor Financier Agent Builder Purchase price/refinance amount of vendor or vendor's agent Other 1st Home 1st Home with FHOG Phone contact no. 2) Will another property be your principal residence? 3) Will the property (being purchased/refinanced) be rented? 4) Will you earn any income as a result of this loan? 5) Is this loan to be used wholly or predominantly for business or investment purposes? Please sign Declarion page If "" has been answered to any of the above, please provide details. Page 1 of 7

2 Personal details - Applicant 1/Guarantor Title Surname Given Name Middle Name Other names commonly known by (if any) Work phone address De of birth Home phone Marital stus Personal mobile Residency stus: Are you an Australian/NZ citizen or are you a permanent resident? Driver's Licence no.. & age of dependants Current residential address Current residential stus Own Mortgage Rent Other (specify) Previous residential address (if current address less than 3 years) Postal address (if not current residential address) Personal details - Applicant 2/Guarantor Title Surname Given Name Middle Name Other names commonly known by (if any) Work phone address De of birth Home phone Marital stus Personal mobile Residency stus: Are you anaustralian/nz citizen or are you a permanent resident? Driver's Licence no.. & age of dependants Current residential address Current residential stus Own Mortgage Rent Other (specify) Previous residential address (if current address less than 3 years) Postal address (if not current residential address) Page 2 of 7

3 Employment details - Applicant 1 (If you are self-employed please also complete the self-employed section on the next page) APPLICANT 1 Employment details Employment type Full Time Home Duties Part Time Retired Casual Other Self Employed Unemployed Current employer Previous employer (only required where present employment is less than 18 months) Employment details - Applicant 2 (If you are self-employed please also complete the self-employed section on the next page) APPLICANT 2 Employment details Employment type Full Time Home Duties Part Time Retired Casual Other Self Employed Unemployed Current employer Previous employer (only required where present employment is less than 18 months) Monthly income details Gross Basic Income Shift Allowance O/T Second Job Rent from Investment Property APPLICANT 1 APPLICANT 2 Rent from Investment Property Rent from Investment Property Family Payments (F/A - A&B Child under 12 years) Pension (Age, Disability, Vet Affairs) Other income (specify) TOTAL Page 3 of 7

4 Self-employed details (This page only to be completed by Self-Employed Applicant/s) Company name/business name ABN/ACN Type of business Company Trust Partnership Sole Trader Nure of business De of incorporion Business address Postal address Co-owner details (to be completed by self-employed applicant/s) Name of director/partner Shareholder/partner details % of ownership Accountant details (to be completed by self-employed applicant/s) Firm name Phone number Fax number IMPORTANT To minimise any delay in processing your applicion, please: 1. Authorise your accountant to speak to us 2. Provide full financial details for the past two financial years signed by a registered accountant or tax agent, including both personal or company (if applicable) tax returns, balance sheets and profit and loss stements. Business purpose declarion I /we declare th the credit to be provided to me/us by the credit provider, Heritage Bank Limited is to be applied wholly or predominantly for business purposes; or investment purposes other than investment in residential property. IMPORTANT You should only sign this declarion if this loan is wholly or predominantly for: business purposes; or investment purposes other than investment in residential property. By signing this declarion you may lose your protection under the Nional Credit Code Signure Signure De De [The declarion must be signed by each person making the declarion] [The de must be the de the declarion is signed or the de the declarion is received by the credit provider] Page 4 of 7

5 Assets If you are making a joint applicion, and you would like to make separe declarions of assets and liabilities, one applicant may tach a separe sheet of paper. TOTAL SAVINGS Institution In the name of Account type and no. Balance Sub total Sale of property-address Settlement completed Funds received from sale of other assets (give description) Funds received from gift (give description) Deposit paid to (name of Agent) Other available funds of property owned 1 of other property owned 2 3 Car(s) - description (make, model and year) Bo(s) - description (make, model and year) Caravan(s) - description (make, model and year) Life insurance Superannuion Shares Bonds Funds position Net proceeds Available funds sub total Personal Effects / Contents Your total assets Purchase price (land cost if applicable) Deposit Paid Construction cost (if applicable) Cash savings Legal and Government fees Sale proceeds LMI to be capitalised (if applicable) Gift Bank fees First Home Owner Grant Stamp duty Other funds Other costs Other funds Total costs [A] Total available [B] Loan required A - B Page 5 of 7

6 Liabilities Existing mortgages and personal loans Lender In the name of Account type and no. Balance Owing Monthly Repayment Refinance " " Continuing credit - for example credit cards, store cards or revolving credit. Lender In the name of Credit limit Balance Owing Monthly Repayment Refinance " " Contingent liabilities (e.g. guarantees on loans, leases, etc) Type of liability Amount guaranteed Amount per month Total liabilities Monthly payment Other regular payments Maintenance payments Rent (if to continue) HECS/HELP Total current monthly payments Monthly payment Security details - Property 1 Do you have an existing mortgage on the property? Please detail Name of 1st mortgagee Account number Title particulars Specify Contact details for valuer to access property Management agent name Management agent phone number Solicitor/conveyancer details Firm name Phone number Fax number Page 6 of 7

7 Security details - Property 2 Do you have an existing mortgage on the property? Please detail Name of 1st mortgagee Account number Title particulars Specify Contact details for valuer to access property Management agent name Management agent phone number Solicitor/conveyancer details Firm name Phone number Fax number Authority to disclose informion to your Mortgage Broker You authorise Heritage Bank to provide the Mortgage Broker, who referred your loan to us, approval details of your loan account number, product type, loan amount, interest re and any arrears position on the loan, whether the loan is funded or whether the loan is discharged. N/A Declarion Were you influenced, persuaded or pressured (by supplier of the goods/services being financed) into applying for this loan with Heritage Bank? Do you have any reasonable belief th any of the details on this applicion form will change in the near future? (such as an intention to leave your employment, pregnancy or illness) Have you ever been bankrupt or entered into an arrangement with your creditors or had a judgement recorded against you? Is there a relionship by blood or marriage between the vendor of any property being mortgaged and any of the applicants? Is there an associion by way of Employer/Employee, Directorship, Shareholding, Partnership or Joint Venture between the vendor of any property being mortgaged and any of the applicants? If "yes" to any of the above provide details below Who will occupy the dwelling? I/we agree to pay all inspection costs, legal fees and other expenses which may be incurred by Heritage in respect of this applicion. I/we agree th the inspection report, together with plans and specificions (if applicable) will be and remain the property of Heritage. I/we agree th Heritage may insure the loan (if approved and accepted) with an approved mortgage insurer, and may disclose to th insurer any informion or documents I/we have given to Heritage to do with this applicion. I/we acknowledge th as a customer of Heritage I/we am/are bound by Heritage's Constitution from time to time. I/we hereby apply for a loan of to be repaid over an approxime term of months. I/we hereby declare th the stements and answers given in this applicion are to the best of my/our knowledge and belief true and correct in every detail, and not misleading. Applicant's signure Applicant's signure De De Page 7 of 7

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