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Mortgage Application Form

To make the form easier to complete we have broken it into eight steps. Before you begin consider the following;

  • The form is detailed and will take up to 10 minutes to complete
  • Make sure you have thought about your monthly budget, assets & liabilities
  • If you only want to make an enquiry and not complete an application please complete the step 1 and click submit.
  • We are sorry, but you can't save the form and come back to it later. If at any point you need help or would prefer to complete it with a broker click submit and both you and Mike Pero will receive a copy.
  • Once you have completed the online application form a Mike Pero broker will be in touch with you within 24 hours.

 

 

Step 1 of 7 - Introduction

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Contact Details

Region of Interest *








Tell us about why you are making this application?



Please enter code

  
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Applicant 1




NZ Residency Held?


Marital Status


Number of Dependents


Current Residential Address


Time at address

Years


Months


If less than 3 years what was your previous address, include years/months at this address

Previous Address


Are you currently?


Home Phone


Work Phone


Mobile Phone


Email


Employment

Main Source of Income


Occupation


Employer/Business Name


Type of Business


Term of Employment

Years


Months


If less than 3 years, what was your previous employment, include years/months at this employment

Previous Employment


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Applicant 2

First Name(s)


Surname



NZ Residency Held?


Marital Status


Number of Dependents


Current Residential Address


Time at address

Years


Months


If less than 3 years what was your previous address, include years/months at this address

Previous Address


Are you currently?


Home Phone


Work Phone


Mobile Phone


Email


Employment

Main Source of Income


Occupation


Employer/Business Name


Type of Business


Term of Employment

Years


Months


If less than 3 years, what was your previous employment, include years/months at this employment

Previous Employment


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Funding Details

Purchase Price or Refinance Mortgage

$

Less

Deposit

$

Other Funds (eg. gifts, loans)

$

Finance Required

$
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Security

Do you own existing properties to be used as security for this application?
Security Property 1

Address


Current Ownership

Intention

Purchase Price

$
Security Property 2

Address


Current Ownership

Intention

Purchase Price

$
Security Property 3

Address


Current Ownership

Intention

Purchase Price

$
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Proposed Monthly Income

At date of application

Salary/Wages

$

Business/Employed

$

Benefits (income support)

$

Interest/Dividends

$

Other

$

Do you have rental properties?

Rental Income 1

Address


Type

Per Week

$
Rental Income 2

Address


Type

Per Week

$
Rental Income 3

Address


Type

Per Week

$

Total Income

$
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Proposed Monthly Expenditure

At date of application

Rental Property Mortages

Total for all rental properties

$
Other Mortgage Repayments

Total for all mortgages

$

Student Loans

$
Hire Purchases

Total repayment amounts

$
Other Loans

Other Loan repayments amount

$

Credit/Charge Cards Repayments

$

Store Cards Repayments

$

Child Support / Child Care

$

Rent to pay

$

Compulsory Superannuation

$

Total Expenses

$
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Statement of Assets

Approximately

Main Bank / Branch


Money @ Bank/Other

1. Bank Name/Value

$

2. Bank Name/Value

$

3. Bank Name/Value

$
Property

1. Address/Value

$

2. Address/Value

$

3. Address/Value

$
Shares

Company/Value

$
Vehicles

1. Make/Value

$

2. Make/Value

$

3. Make/Value

$
Superannuation

1. Provider/Value

(SV) $

2. Provider/Value

(SV) $
Life Insurance

1. Provider

$ k(SV)  $

2. Provider

$ k(SV)  $

3. Provider

$ k(SV)  $

Business value

$

Boat/Caravan

$

Furniture and Personal Effects

$
Other Assets

1. Other

$

2. Other

$

3. Other

$

Total Assests

$
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Statement of Liabilities

Approximately

Overdraft

Bank/Limit/Liability

$ $
Mortgages

1. Bank/Liability

$

2. Bank/Liability

$

3. Bank/Liability

$

4. Bank/Liability

$

5. Bank/Liability

$
Personal Loan

1. From/Liability

$

2. From/Liability

$
Hire Purchases

1. From/Liability

$

2. From/Liability

$
Credit/Store/Charge Cards

1. From/Limit/Liability

$ $

2. From/Limit/Liability

$ $

3. From/Limit/Liability

$ $

Student Loans

$

Other Liabilities

$

Total Liabilities

$

Total (Per Total Assests)

$
Prev
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