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Mortgage Referral Form - Active Money
Mortgage Referral Form - Active Money
Referrer's Details
Preferred Time to Contact You
:
HH
MM
AM
PM
AM/PM
Client Details
Client Name
*
Mobile Number
*
Work Number
Email Address
*
Marital Status
*
Number of Dependents
*
Home Status
*
Own Home
Mortgaged
Renting
Other
Employment Status
*
Employee Full-Time
Employee Part-Time
Self-Employed
Other
Income
*
Spouse Income
Rental Income
Other Income
Would you like us to call you before speaking with the client?
*
Yes
No
What is the purpose of the loan?
*
To buy first home
To buy next home
To buy an investment property
To build a home
To renovate
To refinance
To consolidate debts
To look into a reverse mortgage
To source a commercial loan
Other
If Other, What does your client need the money for?
Loan amount required
*
Is the client a first home buyer?
*
ASSETS AND LIABILITIES
Principal Property
Home Value
Loan Amount
Fixed or Variable?
Fixed
Variable
Lender
Interest Rate?
Investment Property 1
Value
Loan Amount
Fixed or Variable?
Fixed
Variable
Lender
Interest Rate
Weekly Rent Received
Investment Property 2
Value
Loan Amount
Fixed or Variable?
Fixed
Variable
Lender
Interest Rate
Weekly Rent Received
Investment Property 3
Value
Loan Amount
Fixed or Variable?
Fixed
Variable
Lender
Interest Rate
Weekly Rent Received
Savings/Investments
Cash/Savings
Other Funds Available (e.g. Gift)
Other Liabilities
Credit Card Limits
Personal Loan Amount
Monthly Repayment
Weekly Rent Paid
Is there any other information which you believe is relevant?
