"*" indicates required fields X/TwitterThis field is for validation purposes and should be left unchanged.Online Applications are now available. Our Online Application facility is now available. You can apply by filling in the form below. Alternatively, you can download our Application Form by clicking the button below and emailing it to loans@equity-one.com or posting to Level 13, 256 Queen Street Melbourne VIC 3000 Australia. DOWNLOAD APPLICATION FORMSection 1. Who Is Completing This Form?Please indicate whether the person completing this form is the loan applicant or a broker.* I am the loan applicant I am a broker (representative of the applicant) Who Is The Application For?* A Company Individual Applicant(s) Email* Section 1a. Broker / Borrower Representative DetailsPlease provide details of the broker / borrower representative completing this application.Broker Name* First Last Company*Broker Address* Street Address City State / Province / Region ZIP / Postal Code Contact Number*Broker Email* ACL Number Section 2. Applicant DetailsWe require personal details from all applicant(s). If the applicant is a company, please fill in the details for each Director. Select the number of applicants and complete each section below.Number of Applicants / Directors*1234Applicant A / Director AApplicant A Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Applicant A Date of Birth* Applicant A Drivers Licence NumberApplicant A Address* Street Address City State / Province / Region ZIP / Postal Code Applicant A – Will this address change after settlement? Yes No Applicant A New Address (if changing after settlement) Street Address City State / Province / Region ZIP / Postal Code Applicant A – Are you presently bankrupt? Yes No Applicant A – Are you a politically exposed person? Yes No Applicant A – Contact DetailsApplicant A Mobile*Applicant A Email* Applicant A – Employment DetailsApplicant A Occupation*Applicant A Details of IndustryApplicant A Typical Services Provided to ClientsApplicant A Annual Income (before tax)*Applicant A Employer Name (Trading Name if Self Employed)*Applicant A – If returning customer, have there been any changes to your employment?Applicant A – Closest Relative Who Does Not Reside With YouApplicant A Relative Name*Applicant A Relative Relationship*Applicant A Relative Address* Street Address City State / Province / Region ZIP / Postal Code Applicant A Relative Mobile*Applicant A Relative Email* Applicant B / Director BApplicant B Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Applicant B Date of Birth* Applicant B Drivers Licence NumberApplicant B Address* Street Address City State / Province / Region ZIP / Postal Code Applicant B – Will this address change after settlement? Yes No Applicant B New Address (if changing after settlement) Street Address City State / Province / Region ZIP / Postal Code Applicant B – Are you presently bankrupt? Yes No Applicant B – Are you a politically exposed person? Yes No Applicant B – Contact DetailsApplicant B Mobile*Applicant B Email* Applicant B – Employment DetailsApplicant B Occupation*Applicant B Details of IndustryApplicant B Typical Services Provided to ClientsApplicant B Annual Income (before tax)*Applicant B Employer Name (Trading Name if Self Employed)*Applicant B – If returning customer, have there been any changes to your employment?Applicant B – Closest Relative Who Does Not Reside With YouApplicant B Relative Name*Applicant B Relative Relationship*Applicant B Relative Address* Street Address City State / Province / Region ZIP / Postal Code Applicant B Relative Mobile*Applicant B Relative Email* Applicant C / Director CApplicant C Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Applicant C Date of Birth* Applicant C Drivers Licence NumberApplicant C Address* Street Address City State / Province / Region ZIP / Postal Code Applicant C – Will this address change after settlement? Yes No Applicant C New Address (if changing after settlement) Street Address City State / Province / Region ZIP / Postal Code Applicant C – Are you presently bankrupt? Yes No Applicant C – Are you a politically exposed person? Yes No Applicant C – Contact DetailsApplicant C Mobile*Applicant C Email* Applicant C – Employment DetailsApplicant C Occupation*Applicant C Details of IndustryApplicant C Typical Services Provided to ClientsApplicant C Annual Income (before tax)*Applicant C Employer Name (Trading Name if Self Employed)*Applicant C – If returning customer, have there been any changes to your employment?Applicant C – Closest Relative Who Does Not Reside With YouApplicant C Relative Name*Applicant C Relative Relationship*Applicant C Relative Address* Street Address City State / Province / Region ZIP / Postal Code Applicant C Relative Mobile*Applicant C Relative Email* Applicant D / Director DApplicant D Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Applicant D Date of Birth* Applicant D Drivers Licence NumberApplicant D Address* Street Address City State / Province / Region ZIP / Postal Code Applicant D – Will this address change after settlement? Yes No Applicant D New Address (if changing after settlement) Street Address City State / Province / Region ZIP / Postal Code Applicant D – Are you presently bankrupt? Yes No Applicant D – Are you a politically exposed person? Yes No Applicant D – Contact DetailsApplicant D Mobile*Applicant D Email* Applicant D – Employment DetailsApplicant D Occupation*Applicant D Details of IndustryApplicant D Typical Services Provided to ClientsApplicant D Annual Income (before tax)*Applicant D Employer Name (Trading Name if Self Employed)*Applicant D – If returning customer, have there been any changes to your employment?Applicant D – Closest Relative Who Does Not Reside With YouApplicant D Relative Name*Applicant D Relative Relationship*Applicant D Relative Address* Street Address City State / Province / Region ZIP / Postal Code Applicant D Relative Mobile*Applicant D Relative Email* Section 3. Company ApplicationComplete this section only if the applicant(s) is a company. Ensure Director details correspond to applicant details in Section 2 (Director A = Applicant A).Director ADirector A – Company Name*Director A – ACN*Director A – Company Registered Address* Street Address City State / Province / Region ZIP / Postal Code Director A – Annual Company Income*Director A – Details of Typical Service Provided by CompanyDirector A – Is the company a Trustee? Yes No Director A – Name of Trust (if applicable)Director BDirector B – Company Name*Director B – ACN*Director B – Company Registered Address* Street Address City State / Province / Region ZIP / Postal Code Director B – Annual Company Income*Director B – Details of Typical Service Provided by CompanyDirector B – Is the company a Trustee? Yes No Director B – Name of Trust (if applicable)Director CDirector C – Company Name*Director C – ACN*Director C – Company Registered Address* Street Address City State / Province / Region ZIP / Postal Code Director C – Annual Company Income*Director C – Details of Typical Service Provided by CompanyDirector C – Is the company a Trustee? Yes No Director C – Name of Trust (if applicable)Director DDirector D – Company Name*Director D – ACN*Director D – Company Registered Address* Street Address City State / Province / Region ZIP / Postal Code Director D – Annual Company Income*Director D – Details of Typical Service Provided by CompanyDirector D – Is the company a Trustee? Yes No Director D – Name of Trust (if applicable)Section 3.2 – Beneficial OwnersPlease provide details of Beneficial Owners – individuals who control one or more shareholdings totalling 25% or more of the company's issued capital. If there are more than 4, email loans@equity-one.com to request additional pages.Number of Beneficial Owners01234Beneficial Owner – Individual ABeneficial Owner A Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Beneficial Owner A Occupation*Beneficial Owner A Date of Birth* Beneficial Owner A Address* Street Address City State / Province / Region ZIP / Postal Code Beneficial Owner – Individual BBeneficial Owner B Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Beneficial Owner B Occupation*Beneficial Owner B Date of Birth* Beneficial Owner B Address* Street Address City State / Province / Region ZIP / Postal Code Beneficial Owner – Individual CBeneficial Owner C Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Beneficial Owner C Occupation*Beneficial Owner C Date of Birth* Beneficial Owner C Address* Street Address City State / Province / Region ZIP / Postal Code Beneficial Owner – Individual DBeneficial Owner D Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Beneficial Owner D Occupation*Beneficial Owner D Date of Birth* Beneficial Owner D Address* Street Address City State / Province / Region ZIP / Postal Code Section 4. Trust DetailsPlease provide details of Primary Beneficiaries. If there is no Trust, select 0 to proceed to the next section. If there are more than 4 Primary Beneficiaries, email loans@equity-one.com to request additional pages.Number of Primary Beneficiaries*0 – No Trust1234Beneficiary ABeneficiary A Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Beneficiary A Occupation*Beneficiary A Date of Birth* Beneficiary A Address* Street Address City State / Province / Region ZIP / Postal Code Beneficiary BBeneficiary B Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Beneficiary B Occupation*Beneficiary B Date of Birth* Beneficiary B Address* Street Address City State / Province / Region ZIP / Postal Code Beneficiary CBeneficiary C Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Beneficiary C Occupation*Beneficiary C Date of Birth* Beneficiary C Address* Street Address City State / Province / Region ZIP / Postal Code Beneficiary DBeneficiary D Name* Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Beneficiary D Occupation*Beneficiary D Date of Birth* Beneficiary D Address* Street Address City State / Province / Region ZIP / Postal Code AppointorAppointor Name Title (Mr/Mrs/Miss/Other)Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Appointor OccupationAppointor Date of Birth Appointor Address Street Address City State / Province / Region ZIP / Postal Code Section 5. Loan SecurityAll applicants must supply details of the property or properties established as security for this loan. If you plan to use more than 4 individual properties as security, place the first 4 here and additional details in Section 8 (Additional Comments).Number of Security Properties*01234Security Property ASecurity Property A Address* Street Address City State / Province / Region ZIP / Postal Code Security Property A – Estimated Value*Security Property A – Property Classification*ResidentialCommercialRuralIndustrialVacant LandSecurity Property A – Is the property tenanted? Yes No Security Property A – If yes, who is the managing agent?Security Property A – Is there a first mortgage on this property? Yes No Security Property A – If yes, through which lender is the mortgage held?Security Property A – How much is currently owing on the first mortgage?Security Property A – Is there anything else we should be made aware of relating to this property?Security Property BSecurity Property B Address* Street Address City State / Province / Region ZIP / Postal Code Security Property B – Estimated Value*Security Property B – Property Classification*ResidentialCommercialRuralIndustrialVacant LandSecurity Property B – Is the property tenanted? Yes No Security Property B – If yes, who is the managing agent?Security Property B – Is there a first mortgage on this property? Yes No Security Property B – If yes, through which lender is the mortgage held?Security Property B – How much is currently owing on the first mortgage?Security Property B – Is there anything else we should be made aware of relating to this property?Security Property CSecurity Property C Address* Street Address City State / Province / Region ZIP / Postal Code Security Property C – Estimated Value*Security Property C – Property Classification*ResidentialCommercialRuralIndustrialVacant LandSecurity Property C – Is the property tenanted? Yes No Security Property C – If yes, who is the managing agent?Security Property C – Is there a first mortgage on this property? Yes No Security Property C – If yes, through which lender is the mortgage held?Security Property C – How much is currently owing on the first mortgage?Security Property C – Is there anything else we should be made aware of relating to this property?Security Property DSecurity Property D Address* Street Address City State / Province / Region ZIP / Postal Code Security Property D – Estimated Value*Security Property D – Property Classification*ResidentialCommercialRuralIndustrialVacant LandSecurity Property D – Is the property tenanted? Yes No Security Property D – If yes, who is the managing agent?Security Property D – Is there a first mortgage on this property? Yes No Security Property D – If yes, through which lender is the mortgage held?Security Property D – How much is currently owing on the first mortgage?Security Property D – Is there anything else we should be made aware of relating to this property? Section 6. Loan DetailsPlease supply details of the loan for which this application is being completed.Loan Amount ($)*Loan Purpose* Section 7. Additional Assets and LiabilitiesDo you have any other assets or liabilities other than those already stated? If so, please list below.AssetsProperty*Contents*Shares / Investments*Business Goodwill*Other Assets*LiabilitiesOther Loans*Credit Cards*Other Creditors* Section 8. Additional CommentsAdditional Comments Privacy Act 1988 ConsentI/We acknowledge that I/we have made an application for credit from Equity-One Mortgage Fund Limited and they may use the personal information I/we provide for the purpose of providing credit and subject to the provisions of the Privacy Act, I/we may have access to personal information collected and held by Equity-One Mortgage Fund Limited, and the Lenders. I/We may contact these companies for access to my/our personal information held (if any) by contacting the Privacy Officer in writing to Level 13, 256 Queen Street Melbourne.Authority to Exchange Information with Other Credit ProvidersIn accordance with Part IIIA, Division 3 of the Privacy Act, I/we authorise Equity-One Mortgage Fund Limited to give and obtain from credit providers, Personal Property Securities Register, and credit providers that may be named in a credit report issued by a credit reporting agency, information about my/our credit arrangements. I/We understand this information can include any information about my/our credit worthiness, credit standing, credit history, or credit capacity that credit providers are allowed to give or receive from each other under the Privacy Act 1988.The Lender will usually or may disclose personal information of the kind it collects about me/us to: its related companies; reinsurers; credit reporting agencies; its service providers; its agents, contractors, and external advisers; my/our referees, including my/our employer; my/our legal and financial advisers; government and other regulatory bodies; ratings agencies; payment system operators; and other financial institutions, securities and credit providers.Declaration & Signature of Applicant / GuarantorI/We declare that the information contained in this application and attached statements is true and correct in every particular, and I/we are over the age of 18. It is upon this basis that I/we make this application for credit and confirm our agreement to the Privacy Act consent set out above. Please sign and return the downloaded PDF application to loans@equity-one.com or post to Level 13, 256 Queen Street Melbourne VIC 3000 Australia.Declaration I/We confirm the information provided is true and correct, and I/we agree to the Privacy Act 1988 consent terms set out above.
