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PERSONAL AND EMPLOYMENT DETAILS
E stimated Loan Amount $
L oan Purpose
	Individual Applicant 1	Individual Applicant 2
T itle eg: Mr/Mrs/Ms/Miss/Dr
S urname
G iven Name
P resent Home Address
P resent Home Address	Postcode:	Postcode:
P hone Numbers	Work:	Work:
		Home:
		Mobile:
E mail Address
M arital Status
N o of dependants & Ages
O ccupation / Position
E mployer's Name (or "Self" if Self Employed)
T ime with current employer OR time Self-Employed (Yrs / Mths)
A nnual Salary or Annual Self Employed Income

ASSETS	Value $	LIABILITIES	Monthly Payments $	Amount Owing $
H ome		Mortgage with:
P roperty 2		Mortgage with:
P roperty 3		Mortgage with:
M otor Vehicles		Car Loans with:
C ash at Bank		Personal loans with:
P ersonal Effects		Total Credit Card Limits:
S uperannuation		Other Loans:
S hares
O ther Assets

I / We authorise release of the information contained herein to such parties as are necessary to asses and provide information regarding finance / refinancing provided that such information is treated as confidential and restricted to parties affiliated with AUSTRALIAN MORTGAGE BUSTERS and indemnify AUSTRALIAN MORTGAGE BUSTERS. I / we hereby certify the above information to be true accurate and complete. I / We understand that AUSTRALIAN MORTGAGE BUSTERS may receive a fee or commission in relation to this transaction and AUSTRALIAN MORTGAGE BUSTERS may pay a commission or referral fee to an Appointed Agent. (if applicable)

ACCESS TO YOUR PERSONAL INFORMATION

All your personal information held by AUSTRALIAN MORTGAGE BUSTERS will be used and disclosed in accordance with the AUSTRALIAN MORTGAGE BUSTERS Privacy Policy. Subject to the provisions of the Privacy Act 1988, you can arrange access to your personal information held by AUSTRALIAN MORTGAGE BUSTERS and its Appointed Agent by calling the AUSTRALIAN MORTGAGE BUSTERS Helpline on 07 3350 6026

If you do not provide AUSTRALIAN MORTGAGE BUSTERS and its Appointed Agent with the requested personal information, AUSTRALIAN MORTGAGE BUSTERS will not be able to supply you with the products and services requested by you or on your behalf.

You have the right at any time to request AUSTRALIAN MORTGAGE BUSTERS and its Appointed Agent not to telephone you or provide you with any further information about products and services and not to disclose your information to any other organisations (including related corporations) for that purpose. You may do this by calling the AUSTRALIAN MORTGAGE BUSTERS Helpline on 07 3350 6026.

Applicant’s Acknowledgement

I/we acknowledge that I/we have read the above and agree that my/our personal information may be passed to AUSTRALIAN MORTGAGE BUSTERS to be used as stated above. I/we understand that if I/we do not sign this consent and acknowledgement form, the Appointed Agent will not be able to complete my/our services and products requested, and all my/our personal information will be discarded in a safe and secure manner.

Name of Applicant 1: Signature:___________________ Date:

Name of Applicant 2: Signature:___________________ Date:

Name of Applicant 3: Signature:___________________ Date:

Name of Applicant 4: Signature:___________________ Date: