Step 1 of 5 Applicant's Personal Details First Name Middle Name(s) Surname Gender Male Female Date of Birth 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Marital Status Married/De Facto Single Separated Widowed Divorced Number of Dependents Driving License Number Driving License Expiry 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 Street Address Suburb/Town Postcode State Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Norfolk Island Christmas Island Cocos Islands Jervis Bay Territory Email Address Mobile Other Phone Residential Status Own Home Mortgage Renting Boarding Employer Provided Other Step 2 of 5 Duration of Residence Years 0 Years 1 Year 2 Years 3 Years 4 Years 5 Years 5+ Years Months 0 Months 1 Month 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months Applicant's Previous Address Street Address Suburb/Town Applicant's Employment Details Occupation Employment Type Full Time Part Time Casual Contract Self Employed Not Employed Duration of Employment 0 Years 1 Year 2 Years 3 Years 4 Years 5 Years 5+ Years 0 Months 1 Month 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months Employer Name Street Address Suburb/Town Postcode State Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Norfolk Island Christmas Island Cocos Islands Jervis Bay Territory Asset and Liability Details House Asset $ Liability $ Other Properties Asset $ Liability $ Motor Vehicles Asset $ Liability $ Boat or Caravan Asset $ Liability $ Cash in Bank Asset $ Liability $ Furniture Asset $ Liability $ Other Asset $ Liability $ TOTAL Total Assets $ Total Libilities $ Applicant's Financial Details Monthly Income Net Income $ Other Income $ Credit Card Credit Card Limit $ Monthly Expenditure Mortgage/Rent/Board $ Clothing & Personal Care $ Other Repayments $ Medical & Health $ Min. Credit Card Repayment $ Transport $ Utilities & Rates $ Education $ Telephone & Internet $ Child Care $ Groceries $ Insurance $ Entertainment $ Other Expenses $ Totals Total Monthly Income $ Total Monthly Expenditure $ Monthly Surplus $ Step 3 of 5 Goods to be Financed Product Sought Car Truck Bike Boat/PWC Caravan Motorhome/Campervan Home Other Details Vehicle Details New Used Demo Make Model Year Transmission Automatic Manual None Body Type Engine Size (CC or Cylinders) Fuel Type Petrol Diesel LPG Kilometres No. Motors Motor Make Motor Model Motor Size (HP) Fuel Type Step 4 of 5 Financing Requirements Finance Details Private Use Business Use Cash Price (inclusive on-road, drive away pricing) $ Less Cash Deposit $ Trade-In Value $ Finance Company Payout $ Total Term of Loan Required 12 Months (1 Year) 24 Months (2 Years) 36 Months (3 Years) 48 Months (4 Years) 60 Months (5 Years) 72 Months (6 Years) 84 Months (7 Years) Total Finance Sought $ Comprehensive Insurance Payment Method Include Insurance in Loan Pay Insurance Monthly No Insurance Required Years Claim Free 0 1 2 3 4 5 Note: If you include insurance in the loan, the insurance cannot be paid monthly. Your Insurance is part of the monthly loan payment. Step 5 of 5 Terms and Conditions I have read the Credit Guide - Credit Contract / Lease Agreement I have read the Personal and Credit Information Privacy Policy I have read the Client Acknowledgement - Appointment and Quote Forms Declaration of Authority Declaration: The information provided by me in this application is true and correct. I hereby give F & I Management PTY LTD trading as Westcorp Capital, its associated entities and authorised credit representatives it has appointed, authority to proceed with this loan application to a final decision by any of the lenders it has relationships with. I Agree Yes No Purchasing From Dealership Individual Name Is there anything in your credit history that would stop you from getting a loan? Yes No Please Specify Details Will proceeding with this loan place you in financial hardship? Yes No Please Specify Details Back Next
