ONLINE APPLICATION FORM

1. Preliminary Information

*Applying as a...

*Number of applicants:

*Number of guarantors:

*Which type of finance do you require?

*Have you purchased the asset?

*Estimated amount to finance:

Around $50000

2. Main Applicant Details:

*Your Name:

*Your E-mail Address:

*Best Contact Phone Number:

*Postcode or Suburb:

3. A Quick Question:

Where did you hear about us?

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Who is your Finance Consultant?

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3. Personal Details:

Date of birth:

Gender:

Marital Status:

Number of dependent children:

Age of dependent children:

Drivers license state:

Driver license expiry date:

Residency Status:

Visa Sub-Class Number:

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4. Home Residence Details:

Home Ownership:

Country:

Postcode:

Street Address:

Moved into residence:

5. Personal Reference:

Full Name:

Postcode or Suburb:

Street Address:

Contact phone number:

Relationship:

6. Current Employment:

Type of employment:

Date began employment:

Job Title:

Company / Business Name:

Name of payroll contact:

Phone number of payroll contact:

Employer ABN:

Country:

Suburb or Postcode:

Street Address:

7. Financials:

Income

Do you know your after tax (net) salary?

After-tax (net) salary:

Overtime (after tax):

Bonuses (after tax):

Other Income (after tax):

Description of other income:

Your spouses income (after tax):

Details of Foreseen Changes in Income:

How many credit cards do you have?

8. Financials:

Expenses

Household expenses:

Insurance Payments:

Other regular expenses:

Description of other expenses:

9. Financials:

Essentials

Name of main bank:

Name of accountant:

Phone Number of Accountant:

10. Financials:

Credit History

Note: We can assist most clients who have problems with their credit history, but we need to know about any credit problems up-front. Non-disclosure of credit problems will be looked upon unfavorably by our lenders and will compromise any attempt to obtain a loan approval.

Are you currently bankrupt:

Are you discharged bankrupt:

Any other credit problems within the past 7 years:

Have you previously had finance?

11. Assets & Liabilities:

Basic Assets

Cash on hand / in bank:

Value of home's contents that you own:

Superannuation:

Estimated Value of your home:

Estimated Value of any investment properties:

Estimated Value of any plant & equipment:

Estimated Value of any motor vehicles:

Estimated Value of any Boats, Motorbikes or Trucks:

Estimated Value of any other assets:

Basic Liabilities

12. Assets & Liabilities:

Do you have an overdraft?

Do you have a secured loan?

Do you have a un-secured loan?

Do you have any other liabilities?

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Pure Capital Pty Ltd (ABN) 87 628 391 757 are acting as an authorised credit representative (ACL) 389328, Australian Credit Rep no. 512764. Under s65(1) of the National Consumer Credit Protection Act 2009. All offers are “subject to lender criteria & acceptance” & the 0% * application fee is “to approved applicants only”. 0% Application Fee Offer Terms & Conditions: Offer subject to lender criteria & acceptance, fees and charges apply. The 0.00% * application fee offer applies to applications lodged by 10th January 2019. Trademark/ Copyright Disclaimer- No affiliation. Any product names, logos, brands, and other registered® trademarks™ or images featured or referred to within www.purecapital.com.au website are the property of their respective trademark holders. Use of them does not imply any affiliation with or endorsement by them. We work with Alphera financial services under a referral basis only. None of the examples, and/or pictures are affiliated, endorsed or sponsored by the manufacturer. Or of the trademark or corporation We declare no affiliation, sponsorship, nor any partnerships with any registered trademarks ,manufacturers or company names. We stand independently as the sole operators of Pure Capital Pty Ltd. We are proud of the fact that we do not need any sponsorship, or any partnerships with any other companies to provide our service and/or product.

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