Gold Rat Client Enquiry Form

Loan Purpose *Provide a detailed description of the intended use of funds

Purchasing From *

Private SellerBusinessUndecided

Requested Loan Amount *

Requested Loan Term (2-7 Years) *

Optional Comments *Any other comments you would like to share

Borrower

First Name *

Middle Name

Last Name *

Mobile Number *

Email *

Date Of Birth *

Gender *

MaleFemale

Marital Status *

Number of Dependents *

Have you ever been declared Bankrupt *If Yes, how many years ago?

Do you currently have a Default on your Credit Report *If Yes, how many years ago?

Driver License (Front) *

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Drivers License (Back) *

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Medicare Card

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Optional CommentsAny other comments you would like to share

Optional Documentation

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Optional Documentation

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Residential Status

Residential Details

Number of years at your current address? *

Residentual Address *

Street address *

City *

State *

Postcode *

Optional CommentsAny other comments you would like to share

Optional Documents

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Optional Documents

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Employment

Approx Employment Start Date

Employment Type *

Still On Probation Period

YesNo

Employer name

Job Description

Employer phone number

Income Amount - per cycle (Before Tax) *

Payment Cycle *

WeeklyFortnightlyMonthly

Current Pay Slip 1 of 2

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Current Pay Slip 2 of 2

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Centrelink Statement

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Optional CommentsAny other comments you would like to share

Optional Documents

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Self Employed

Comany Name

ABN

Are you registered for GST

YesNo

Notice of Assessment (NOA)

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Income Tax Return (ITR)

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Other 1

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Other 2

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Optional CommentsAny other comments you would like to share

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Liabilities: Mortgage Repayments / Rental Payments

Mortgage / Rent (Per Month) *

% Share of PaymentDo you live alone and pay 100% or Share and pay 50% / 25%

Optional CommentsAny other comments you would like to share

Optional Documents

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Optional Documents

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Liabilities: Loans / Credit Cards / BNPL / LIVING EXPENSE

Car LoanPlease provide the lender name, credit limit, and outstanding amount

Personal LoanPlease provide the lender name, credit limit, and outstanding amount

Other Loan 1Please provide the lender name, credit limit, and outstanding amount

Other Loan 2Please provide the lender name, credit limit, and outstanding amount

Credit Card 1Please provide the lender name, credit limit, and outstanding amount

Credit Card 2Please provide the lender name, credit limit, and outstanding amount

Credit Card 3Please provide the lender name, credit limit, and outstanding amount

Interest Free CardsPlease provide the lender name, credit limit, and outstanding amount

AfterPayPlease provide the lender name, credit limit, and outstanding amount

ZipPay/OtherPlease provide the lender name, credit limit, and outstanding amount

Total Combined Repayments Of Current Liabilities (Per Month) *Total Repayments Per Month

Monthly General Living Expense *Groceries, Clothing, Utilities, Phone, Transport, Compulsory Insurance, Health, Education, Childcare and Body Corporate. Do not include your Rent/Mortgage payments, Credit Card and Loan Repayments.

Optional CommentsAny other comments you would like to share

Optional Documents

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Additional Information

Optional CommentsAny other comments you would like to share

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ACKNOWLEDGMENT

Ensure all required information and documentation have been provided and completed. Please note, we cannot begin processing your application until all requested information and supporting documents have been received. Submitting only part of the Client Enquiry Form or failing to upload all required documents may significantly delay your application.

Please note that you will receive a separate email containing the Credit Guide and Privacy Consent. This document must be signed digitally before we are able to commence work on your file. Completion of this step is mandatory to ensure compliance with the Finance Brokers Act and our internal compliance policies.

Please sign to confirm the above application details and acknowledgment *

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Date of signature *