Easy Payment Plan

Please complete this form. Mac Lifestyle will assess your application and contact you directly.

1. Personal Details
Title Surname* Full Given Names*
A value is required. A value is required.
Home Phone Work Phone Mobile Phone
Number Of Depandants Ages (eg: 3, 5, 11) Email Address*
A value is required.Invalid format.
Loan Amount($) Introducer  
 
Date Of Birth Sex Marital Status Driving License Number
Male      Female

2. Income Details
Net Monthly Job Description Occupation Name Of Employer How Long
yrs   mths
Work Street Address Suburb State  
 

3. Assets
  Owner Market Value
Personal Home Self      Joint  
Investment Property Self      Joint
Bank Balance Self       Joint

4. Other Assets
  Owner Company Policy Number 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 Arrangment
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 Lifestyle 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

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