RedCap Finance Brokers Business Loan Data Collection Form

RedCap Finance Brokers

Client Business Data Collection Form
FREE Borrrowing Capacity Assessment Form

Enter your data below and a Consultant will be in contact with you to discuss your Maximum Borrowing Capacity results shortly.
Type of Loan Required

Business Loan - UNSECURED Business Loan - SECURED Business Loan - Equipment Funding Business Loan - New Business Startup Options Business Startup - CONSULTATION Business Tuneup - CONSULTATION Home Loan Investment Loan
Your Personal Details
Title: *
Your Preferred Title
Name *

First Name Middle Name Last Name Suffix
Birth Date *

Day Month Year
Marital Status: *

Single Married Defacto Separated
E-mail *
Best Contact Email Address
Phone *

Area Code Phone Number
Mobile Phone *

Address *

Street Address
Street Address Line 2
City	State
Zip Code	Country

How long have you lived in your given address? *

0-1 Year 1-2 Years 3-4 Years 5+ Years
Your Business Information
Business Name
ACN (if Applicable)
ABN
Registered for GST

Yes No
Owners' Name/s
Industry
Years in Business
Ownership Structure

Sole Trader Partnership Private Company Public Company Discretionary Trust with Company Trustee Discretionary Trust with Individual Trustee/s
Business Story
Gross monthly income *
The amount you get BEFORE you pay TAX or any other deductions.
How Urgent is Funding Required

24-36 hours 1-4 weeks 1-6 months
Have you applied elsewhere for this funding, Please explain in full.
Your Personal Employment Information
Present Employer *
Occupation *
Years of experience *

0-1 Year 1-2 Years 3-4 Years 5+ Years
Gross monthly income *
The amount you get BEFORE you pay TAX or any other deductions.
Monthly rent or mortgage payments *
Multiply Your weekly amount x 52 and divide by 12
Total Credit Card Limits *
Add up the limits on all of your credit cards, store cards (Not what you owe)
Total Monthly Repayments for all other loans *
Multiply Your weekly amount x 52 and divide by 12
Genuine Savings *
Amount you have saved that is in your Bank Account
Gifted amounts to be used for your deposit *
Non-Repayble Gifts that are evidenced by a Statutory Declaration
Borrowed Deposit Amount *
Repayable gifts/loans that you can use for your deposit
Comments:
I authorise RedCap Finance Brokers and their associated third party referral partners to obtain and share personal and credit information about me from my employer and credit bureau, or credit reporting agency, any person who has or may have any financial dealing with me, or from any references I have provided. This information, as well as that provided by me in the application, will be referred to in connection with this loan application and any other relationships we may establish from time to time whether by mutual thrid party agreement or required to by law. Any personal and credit information obtained may be disclosed from time to time to other lenders, credit bureaus or other credit reporting agencies. *

YES NO
I hereby declare that the information given by me is true, accurate and complete as of the date of this application submission. *

YES NO
Enter the message as it's shown to verify that you agree to submit your personal information to us. *
RedCap Finance Brokers BDM for EZFinance - Australian Credit Licence Number #392611
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RedCap Finance Brokers

FREE Borrrowing Capacity Assessment Form

Your Personal Details

Your Business Information

Your Personal Employment Information