Applicants Information Collection form - Private & Confidential

Please complete the application below and someone from MAC Credit will contact you.
1 PERSONAL DETAILS
Title Surname*
Full given names*
Home phone Work phone Mobile phone
Number of depandants Ages (ex:3,5,11)  
 
Email address*
Loan Amount($) Practise/Doctor
Date of birth  Sex Marital status Driving license number
Male Female
2 INCOME DETAILS
Net monthly Job description Occupation Name of employer How long
years month
Work street address Suburb State  
 
  Name of employer How long
Previous employment if current less then 3 years years month
3 ASSETS
  Owner Market value
Personal home Self       Joint  
Investment property Self       Joint
Bank Balance Self       Joint
4 OTHER ASSETS
  Owner Market value    
Motor vehicle Self       Joint    
Home content Self       Joint    
Other Self       Joint    
5 LIABILITIES
  Owner Company Credit limit Balance owing
Credit card 1 Self       Joint
Credit card 2 Self       Joint
Credit card 3 Self       Joint
 
  Owner Mortgagor Balance owing Montly repayment
Home loan Self       Joint
Investment property Self       Joint
Personal loan Self       Joint
Car loan Self       Joint
Other Self       Joint
6 LIVING ARRANGEMENT
Current living Current address if renting, real estate name, suburb
weekly rent and time at address

Previous living 		Previous address if living for less than
3 years at current address		 if renting, real estate name, suburb
weekly rent and time at address
Reference/Next
of Kin Name		 Reference/Next of Kin Address Reference/Next of Kin home number ONLY
7 CREDIT HISTORY
Have you ever been bankrupt or have any paid or unpaid defaults or court judgements? No    Yes
If yes, please provide details
Privacy authorisation:
Mac Credit values and respects your rights to privacy of personal information. In order to assess your application please be aware of the following information and provide us with your consent to collect and use your information. Without this consent we may not be able to consider your application.
Please read our privacy authorisation form.

Declarations: I have read and understood the privacy statement in this form and I consent to the collection, use and disclosure of personal information in accordance with the privacy statement.
 
Do you agree to a Veda (CRAA) check?
Yes      No
 

Click here to fill in another application for your partner