Application
Form

Privacy
Agreement
Form

1) INDIVIDUAL APPLICANTS AND/OR GUARANTORS
Applicant 1 or Guarantor 1
TitleMr | Mrs | Miss | Ms | Dr
Surname Age:
Given Names DOB:
Drivers Licence Number
Correspondence Address
Postcode
Residential Address
Postcode
No. of Years
Email
Phone
Employer No. of Years
Occupation
Gross Income PA$
Accountant Ph:
Applicant 2 or Guarantor 2
TitleMr | Mrs | Miss | Ms | Dr
Surname Age:
Given Names DOB:
Drivers Licence Number
Correspondence Address
Postcode
Residential Address
Postcode
No. of Years
Employer No. of Years
Occupation
Gross Income PA$
Accountant Ph:

2) CORPORATE BORROWER
Company Name
ACN
Name of Trust
Date of Incorporation
Correspondence Address
Postcode
Registered Office
Postcode
Name of All Directors
Name of All Shareholders

3) LOAN PURPOSE
Amount Required Preferred Interest Rate %
Loan Purpose Term of Loan
Is the loan purpose predominantly (more than 50%) for investment or business purposes?
Solicitor acting for you Telephone
Name of Finance Broker Telephone
Who referred you to Chevron Mortgage & Loans?

4) STATEMENT OF ASSETS & LIABILITIES (INDIVIDUALS / GUARANTORS)
ASSETSVALUELIABILITIESREPAY
P.M.		AMOUNT
OWING
Property Address Existing Lender  
1.
2.
3.
Motor Vehicles
Savings - Institution
Furniture & Personal Effects
Total AssetsTotal Liabilities 

5) PLEASE DESCRIBE IN DETAIL THE PURPOSE OF THIS LOAN (DETAILED DESCRIPTION REQUIRED)
Loan amount required $ Net (ie. After setup costs)
Term Required: MonthsDate Required:

6) LOAN REPAYMENT - PLEASE STATE HOW IT'S INTENDED TO REPAY THIS LOAN (I.E. SALE OF HOUSE, RE-FINANCING, BUSINESS PROFITS, ETC)(A DETAILED DESCRIPTION IS REQUIRED)

7) AUTHORITY TO EXCHANGE INFORMATION WITH MORTGAGEES
I/We authorise Chevron Mortgage & Loans or its agents to exchange information about me/us with all Mortgagees of the properties listed at paragraph 7 of this Loan Application as Mortgage Securities to enable Chevron Mortgage & Loans To register a mortgage over such properties should financial accommodation be extend by Chevron Mortgage & Loans To me/us, and to enable Chevron Mortgage & Loans to enforce such mortgages should I/we be in default under the terms of the mortgagees and/or the financial accommodation.

The above mentioned addition to the Loan agreement assumes the Applicant for the loan is also the registered proprietor of the Mortgage security. If the mortgage security is registered to another party, then such party should also be required to sign a similarly worded Privacy Declaration to enable Chevron Mortgage & Loans to liaise with any prior or subsequent mortgagees.

8) SOLICITOR DETAILS
Name of Solicitor: Company:
Contact No: Facsimilie No:
Address:
Email address:

9) MORTGAGE SECURITY (TO BE COMPLETED FOR EACH PROPERTY IF BEING USED AS SECURITY)
Property 1 Address:
Mortgaged to:
Amount Owing: Payments up to Date:
No. Bedrooms No. Bathrooms Ensuite Family/Games
No. Story's Car Spaces Block Size Zoning
Air Con Pool Shed Approx Age:
Construction: Roof:
Key Features:
Property Type: House: | Unit: | Commercial: | Vacant Land:
Property Access - Contact Details for Appraisal Purpose
Name: Phone:
Inspection Details:
 
Property 2 Address:
Mortgaged to:
Amount Owing: Payments up to Date:
No. Bedrooms No. Bathrooms Ensuite Family/Games
No. Story's Car Spaces Block Size Zoning
Air Con Pool Shed Approx Age:
Construction: Roof:
Key Features:
Property Type: House: | Unit: | Commercial: | Vacant Land:
Property Access - Contact Details for Appraisal Purpose
Name: Phone:
Inspection Details:

10) APPLICANTS DECLARATION
By clicking Submit, I / We declare that the foregoing particulars are to the best of my / our knowledge and belief, are true and correct, and that no information is being or has been withheld that might affect the decision of Chevron Mortgage & Loans.

CHEVRON MORTGAGE & LOANS ©2016      |     PO Box 179, Chevron Island QLD 4217      |      PH: 07 5531 5990     |     Fax: 07 5531 6923     |     E Website