The following form is an obligation free enquiry with Viclend; we assess your situation as a free service and explain how we can help you.

Please fill out the following form so that a Viclend friendly consultant can asses your loan enquiry and contact you with a Viclend solution to your requirements, free of charge.

Please note that all fields marked with a ( ) are compulsory.

Title	Please Select ... Dr Miss Mr Mrs Ms Prof Sir
First Name
Surname
Contact Number * include area code if land line

 

Loan Purpose	Please Select ... To purchase a residence for owner-occupation To refinance an owner-occupied residence for personal use To refinance an owner-occupied residence for business use To purchase a property for investment purposes To refinance a property for investment purposes To finance the construction of a residence to be owner-occupied To finance the construction of a property for investment purposes To provide a line of credit for personal use To provide a line of credit for business/ investment use To have available credit to make personal purchases To provide funds for future investment use To provide funds for future personal use Other
Loan Amount

 

Borrower 1		Borrower 2
Marital Status	Please Select ... DeFacto Divorced Married Other Seperated Single Widowed	Marital Status	Please Select ... DeFacto Divorced Married Other Seperated Single Widowed
No. of Dependants	Please Select ... 0 1 2 3 4 5	No. of Dependants	Please Select ... 0 1 2 3 4 5

 

Borrower 1		Borrower 2
Gross Base Salary		Gross Base Salary
Taxable Income (if self employed)		Taxable Income (if self employed)
Length of Employment		Length of Employment
Rental Income		Rental Income
Other Income		Other Income
Savings		Savings

 

Borrower 1		Borrower 2
Liability 1	Please Select ... Residential mortgage Vacant land mortgage Investment mortgage Motor vehicle Credit card limit Personal loan Other	Liability 1	Please Select ... Residential mortgage Vacant land mortgage Investment mortgage Motor vehicle Credit card limit Personal loan Other
Amount Owing		Amount Owing
Monthly Payments		Monthly Payments
Liability 2	Please Select ... Residential mortgage Vacant land mortgage Investment mortgage Motor vehicle Credit card limit Personal loan Other	Liability 2	Please Select ... Residential mortgage Vacant land mortgage Investment mortgage Motor vehicle Credit card limit Personal loan Other
Amount Owing		Amount Owing
Monthly Payments		Monthly Payments
Liability 3	Please Select ... Residential mortgage Vacant land mortgage Investment mortgage Motor vehicle Credit card limit Personal loan Other	Liability 3	Please Select ... Residential mortgage Vacant land mortgage Investment mortgage Motor vehicle Credit card limit Personal loan Other
Amount Owing		Amount Owing
Monthly Payments		Monthly Payments
Liability 4	Please Select ... Residential mortgage Vacant land mortgage Investment mortgage Motor vehicle Credit card limit Personal loan Other	Liability 4	Please Select ... Residential mortgage Vacant land mortgage Investment mortgage Motor vehicle Credit card limit Personal loan Other
Amount Owing		Amount Owing
Monthly Payments		Monthly Payments

* If you have more than 4 liabilities, in ‘Liability 4’ please choose Other and add the totals of the remainder of you liabilities.