Loan & Mandate Applications

Loan Questionnaire Header

Full Name

Is your property located on a main road ie: transport route Is your property located on a main road ie: transport route Yes No

Are you aware of any planning design that may affect your property Are you aware of any planning design that may affect your property Yes No

Is your property located in an over land flow path or flood plain Is your property located in an over land flow path or flood plain Yes No

Is your property within 200m of high voltage power lines Is your property within 200m of high voltage power lines Yes No

Does any property being used as security have a shared driveway Does any property being used as security have a shared driveway Yes No

Is the property being used as a security in a designated high wind zone ie: cliff top ridge Is the property being used as a security in a designated high wind zone ie: cliff top ridge Yes No

Has GST been claimed or do you intend to claim GST on any property to be used as security Has GST been claimed or do you intend to claim GST on any property to be used as security Yes No

If you have answered yes to any of the above please put details below.

Are the funds required for commercial purposes ie: to be used for development, commercial funding, renovation to deliver profit Are the funds required for commercial purposes ie: to be used for development, commercial funding, renovation to deliver profit Yes No

Have you taken legal independent advice in relation to the loan advance from your solicitor Have you taken legal independent advice in relation to the loan advance from your solicitor Yes No

Have you sought advice from your accountant in relation to this loan advance Have you sought advice from your accountant in relation to this loan advance Yes No

Have you enclosed your last 6 months bank statements showing previous mortgage payment history Have you enclosed your last 6 months bank statements showing previous mortgage payment history Yes No

I understand that any loan entered shall be for the term of 12 calendar months. I understand that any loan entered shall be for the term of 12 calendar months. Yes No

I understand that the loan acceptance fee from the lender shall be 2.5% of the total loan value I understand that the loan acceptance fee from the lender shall be 2.5% of the total loan value Yes No

If the loan is approved the interest rate will be between 10.5 – 12.5% at the sole discretion of the Lender If the loan is approved the interest rate will be between 10.5 – 12.5% at the sole discretion of the Lender Yes No

The broker fees upon acceptance of the loan will be 1% in arranging this loan facility The broker fees upon acceptance of the loan will be 1% in arranging this loan facility Yes No

I understand that all legal fees incurred by the lender shall be paid by the borrower and from part of the loan document I understand that all legal fees incurred by the lender shall be paid by the borrower and from part of the loan document Yes No

I understand that if the loan falls into default at any time that the default interest rate shall be 24% plus any legal fees that may be incurred by the lender in remedying the loan I understand that if the loan falls into default at any time that the default interest rate shall be 24% plus any legal fees that may be incurred by the lender in remedying the loan Yes No

I have enclosed my income statement to support this loan application I have enclosed my income statement to support this loan application Yes No

Attachments

If you have answered yes to any of the above please put details below.

Terms and Conditions Terms and Conditions I have read and agreed with the terms and conditions

Signature

Date:

I have no current loan in any entity that I am involved with in default I have no current loan in any entity that I am involved with in default Yes No