secure.capitalempire.com.au
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URL:
https://secure.capitalempire.com.au/
Submission: On September 15 via automatic, source certstream-suspicious — Scanned from DE
Submission: On September 15 via automatic, source certstream-suspicious — Scanned from DE
Form analysis 1 forms found in the DOM
POST /
<form method="post" enctype="multipart/form-data" id="gform_16" action="/">
<div class="gform_heading">
<span class="gform_description">Please complete the following application form. Once you submit it, you will be giving the opportunity to print and sign the form.</span>
</div>
<div class="gform_body">
<ul id="gform_fields_16" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_16_289" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden"><label class="gfield_label" for="input_16_289">Application Reference #</label>
<div class="ginput_container ginput_container_hidden"><input name="input_289" id="input_16_289" type="hidden" value=""></div>
</li>
<li id="field_16_332" class="gfield type_of_finance expand_out gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Type of Finance Required<span
class="gfield_required">*</span></label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_332">
<li class="gchoice_16_332_0"><input name="input_332" type="radio" value="Construction Finance" id="choice_16_332_0" tabindex="1" onclick="gf_apply_rules(16,[81,333]);" onkeypress="gf_apply_rules(16,[81,333]);"><label for="choice_16_332_0"
id="label_16_332_0">Construction Finance</label></li>
<li class="gchoice_16_332_1"><input name="input_332" type="radio" value="Immediate Short Term Finance" id="choice_16_332_1" tabindex="2" onclick="gf_apply_rules(16,[81,333]);" onkeypress="gf_apply_rules(16,[81,333]);"><label
for="choice_16_332_1" id="label_16_332_1">Immediate Short Term Finance</label></li>
</ul>
</div>
</li>
<li id="field_16_134" class="gfield gf_list_inline expand_out field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Did somebody refer you to this loan?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_134">
<li class="gchoice_16_134_0"><input name="input_134" type="radio" value="No" id="choice_16_134_0" tabindex="3" onclick="gf_apply_rules(16,[18,18]);" onkeypress="gf_apply_rules(16,[18,18]);"><label for="choice_16_134_0"
id="label_16_134_0">No</label></li>
<li class="gchoice_16_134_1"><input name="input_134" type="radio" value="Yes" id="choice_16_134_1" tabindex="4" onclick="gf_apply_rules(16,[18,18]);" onkeypress="gf_apply_rules(16,[18,18]);"><label for="choice_16_134_1"
id="label_16_134_1">Yes</label></li>
</ul>
</div>
</li>
<li id="field_16_18" class="gfield gsection section_title field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h2 class="gsection_title"></h2>
</li>
<li id="field_16_284" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h4>Referrer's Details</h4>
</li>
<li id="field_16_135" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_135">Referrer's Full Name</label>
<div class="ginput_container ginput_container_text"><input name="input_135" id="input_16_135" type="text" value="" class="medium" tabindex="5" aria-invalid="false"></div>
</li>
<li id="field_16_19" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_19">Referrer's Email Address</label>
<div class="ginput_container ginput_container_email">
<input name="input_19" id="input_16_19" type="text" value="" class="medium" tabindex="6" aria-invalid="false">
</div>
</li>
<li id="field_16_20" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_20">Referrer's Mobile Number</label>
<div class="ginput_container ginput_container_text"><input name="input_20" id="input_16_20" type="text" value="" class="medium" tabindex="7" aria-invalid="false"></div>
</li>
<li id="field_16_103" class="gfield gsection main_section field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title">Applicant Details <span class="m_expand"><span class="m_expand_text">EXPAND <i class="fa fa-chevron-circle-right"></i></span><span class="m_collapse_text"></span></span></h2>
</li>
<div class="m_section" style="display: none;">
<li id="field_16_207" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible">
<h4>Applicant 1</h4>
</li>
<li id="field_16_106" class="gfield gf_list_3col field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Capacity of Applicant</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_106">
<li class="gchoice_16_106_0"><input name="input_106" type="radio" value="Borrower" id="choice_16_106_0" tabindex="8"><label for="choice_16_106_0" id="label_16_106_0">Borrower</label></li>
<li class="gchoice_16_106_1"><input name="input_106" type="radio" value="Guarantor" id="choice_16_106_1" tabindex="9"><label for="choice_16_106_1" id="label_16_106_1">Guarantor</label></li>
<li class="gchoice_16_106_2"><input name="input_106" type="radio" value="Joint Applicant" id="choice_16_106_2" tabindex="10"><label for="choice_16_106_2" id="label_16_106_2">Joint Applicant</label></li>
</ul>
</div>
</li>
<li id="field_16_107" class="gfield gf_left_half copy-107-to-217 gwcopy gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_107">Full Name<span
class="gfield_required">*</span></label>
<div class="ginput_container ginput_container_text"><input name="input_107" id="input_16_107" type="text" value="" class="medium" tabindex="11" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_16_108" class="gfield gf_right_half copy-108-to-35 gwcopy gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_108">Mobile / Telephone<span
class="gfield_required">*</span></label>
<div class="ginput_container ginput_container_text"><input name="input_108" id="input_16_108" type="text" value="" class="medium" tabindex="12" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_16_138" class="gfield gf_left_half copy-138-to-214 gwcopy gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_138">Email<span
class="gfield_required">*</span></label>
<div class="ginput_container ginput_container_email">
<input name="input_138" id="input_16_138" type="text" value="" class="medium" tabindex="13" aria-required="true" aria-invalid="false">
</div>
</li>
<li id="field_16_136" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_136">Occupation / Position</label>
<div class="ginput_container ginput_container_text"><input name="input_136" id="input_16_136" type="text" value="" class="medium" tabindex="14" aria-invalid="false"></div>
</li>
<li id="field_16_291" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_291">Home Street Address</label>
<div class="ginput_container ginput_container_text"><input name="input_291" id="input_16_291" type="text" value="" class="medium" tabindex="15" aria-invalid="false"></div>
</li>
<li id="field_16_292" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_292">Suburb</label>
<div class="ginput_container ginput_container_text"><input name="input_292" id="input_16_292" type="text" value="" class="medium" tabindex="16" aria-invalid="false"></div>
</li>
<li id="field_16_293" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_293">State</label>
<div class="ginput_container ginput_container_select"><select name="input_293" id="input_16_293" class="medium gfield_select" tabindex="17" aria-invalid="false">
<option value=""></option>
<option value="NSW">NSW</option>
<option value="VIC">VIC</option>
<option value="ACT">ACT</option>
<option value="WA">WA</option>
<option value="TAS">TAS</option>
<option value="NT">NT</option>
</select></div>
</li>
<li id="field_16_294" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_294">Post Code</label>
<div class="ginput_container ginput_container_text"><input name="input_294" id="input_16_294" type="text" value="" class="medium" tabindex="18" aria-invalid="false"></div>
</li>
<li id="field_16_111" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_111">Driver's Licence No.</label>
<div class="ginput_container ginput_container_text"><input name="input_111" id="input_16_111" type="text" value="" class="medium" tabindex="19" aria-invalid="false"></div>
</li>
<li id="field_16_122" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_122">Date of Birth</label>
<div class="ginput_container ginput_container_text"><input name="input_122" id="input_16_122" type="text" value="" class="medium" tabindex="20" aria-invalid="false"></div>
</li>
<li id="field_16_123" class="gfield gf_left_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Home Ownership Status</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_123">
<li class="gchoice_16_123_0"><input name="input_123" type="radio" value="Own" id="choice_16_123_0" tabindex="21"><label for="choice_16_123_0" id="label_16_123_0">Own</label></li>
<li class="gchoice_16_123_1"><input name="input_123" type="radio" value="Rent" id="choice_16_123_1" tabindex="22"><label for="choice_16_123_1" id="label_16_123_1">Rent</label></li>
<li class="gchoice_16_123_2"><input name="input_123" type="radio" value="gf_other_choice" id="choice_16_123_2" tabindex="23" onfocus="jQuery(this).next('input').focus();"><input id="input_16_123_other" name="input_123_other" type="text"
value="Other" aria-label="Other" onfocus="jQuery(this).prev("input")[0].click(); if(jQuery(this).val() == "Other") { jQuery(this).val(""); }"
onblur="if(jQuery(this).val().replace(" ", "") == "") { jQuery(this).val("Other"); }" tabindex="23"></li>
</ul>
</div>
</li>
<li id="field_16_124" class="gfield gf_right_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Residency Status</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_124">
<li class="gchoice_16_124_0"><input name="input_124" type="radio" value="Australian Citizen" id="choice_16_124_0" tabindex="24"><label for="choice_16_124_0" id="label_16_124_0">Australian Citizen</label></li>
<li class="gchoice_16_124_1"><input name="input_124" type="radio" value="Permanent Resident" id="choice_16_124_1" tabindex="25"><label for="choice_16_124_1" id="label_16_124_1">Permanent Resident</label></li>
<li class="gchoice_16_124_2"><input name="input_124" type="radio" value="gf_other_choice" id="choice_16_124_2" tabindex="26" onfocus="jQuery(this).next('input').focus();"><input id="input_16_124_other" name="input_124_other" type="text"
value="Other" aria-label="Other" onfocus="jQuery(this).prev("input")[0].click(); if(jQuery(this).val() == "Other") { jQuery(this).val(""); }"
onblur="if(jQuery(this).val().replace(" ", "") == "") { jQuery(this).val("Other"); }" tabindex="26"></li>
</ul>
</div>
</li>
<li id="field_16_121" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_121">Years at Home Address</label>
<div class="ginput_container ginput_container_text"><input name="input_121" id="input_16_121" type="text" value="" class="medium" tabindex="27" aria-invalid="false"></div>
</li>
<li id="field_16_112" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_112">Business Ownership %</label>
<div class="ginput_container ginput_container_text"><input name="input_112" id="input_16_112" type="text" value="" class="medium" tabindex="28" aria-invalid="false"></div>
</li>
<li id="field_16_102" class="gfield gf_list_inline hide_on_pdf expand_out field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Add Applicant 2?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_102">
<li class="gchoice_16_102_0"><input name="input_102" type="radio" value="No" checked="checked" id="choice_16_102_0" tabindex="29" onclick="gf_apply_rules(16,[105,105,233,233,225,225]);"
onkeypress="gf_apply_rules(16,[105,105,233,233,225,225]);"><label for="choice_16_102_0" id="label_16_102_0">No</label></li>
<li class="gchoice_16_102_1"><input name="input_102" type="radio" value="Yes" id="choice_16_102_1" tabindex="30" onclick="gf_apply_rules(16,[105,105,233,233,225,225]);" onkeypress="gf_apply_rules(16,[105,105,233,233,225,225]);"><label
for="choice_16_102_1" id="label_16_102_1">Yes</label></li>
</ul>
</div>
</li>
<li id="field_16_105" class="gfield gsection main_section_subsection field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h2 class="gsection_title"></h2>
</li>
<li id="field_16_208" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h4>Applicant 2</h4>
</li>
<li id="field_16_24" class="gfield gf_list_3col field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Capacity of Applicant</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_24">
<li class="gchoice_16_24_0"><input name="input_24" type="radio" value="Borrower" id="choice_16_24_0" tabindex="31"><label for="choice_16_24_0" id="label_16_24_0">Borrower</label></li>
<li class="gchoice_16_24_1"><input name="input_24" type="radio" value="Guarantor" id="choice_16_24_1" tabindex="32"><label for="choice_16_24_1" id="label_16_24_1">Guarantor</label></li>
<li class="gchoice_16_24_2"><input name="input_24" type="radio" value="Joint Applicant" id="choice_16_24_2" tabindex="33"><label for="choice_16_24_2" id="label_16_24_2">Joint Applicant</label></li>
</ul>
</div>
</li>
<li id="field_16_88" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_88">Full Name</label>
<div class="ginput_container ginput_container_text"><input name="input_88" id="input_16_88" type="text" value="" class="medium" tabindex="34" aria-invalid="false"></div>
</li>
<li id="field_16_95" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_95">Mobile / Telephone</label>
<div class="ginput_container ginput_container_text"><input name="input_95" id="input_16_95" type="text" value="" class="medium" tabindex="35" aria-invalid="false"></div>
</li>
<li id="field_16_139" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_139">Occupation / Position</label>
<div class="ginput_container ginput_container_text"><input name="input_139" id="input_16_139" type="text" value="" class="medium" tabindex="36" aria-invalid="false"></div>
</li>
<li id="field_16_142" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_142">Email</label>
<div class="ginput_container ginput_container_email">
<input name="input_142" id="input_16_142" type="text" value="" class="medium" tabindex="37" aria-invalid="false">
</div>
</li>
<li id="field_16_295" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_295">Home Street Address</label>
<div class="ginput_container ginput_container_text"><input name="input_295" id="input_16_295" type="text" value="" class="medium" tabindex="38" aria-invalid="false"></div>
</li>
<li id="field_16_296" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_296">Suburb</label>
<div class="ginput_container ginput_container_text"><input name="input_296" id="input_16_296" type="text" value="" class="medium" tabindex="39" aria-invalid="false"></div>
</li>
<li id="field_16_297" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_297">State</label>
<div class="ginput_container ginput_container_select"><select name="input_297" id="input_16_297" class="medium gfield_select" aria-invalid="false">
<option value=""></option>
<option value="NSW">NSW</option>
<option value="VIC">VIC</option>
<option value="ACT">ACT</option>
<option value="WA">WA</option>
<option value="TAS">TAS</option>
<option value="NT">NT</option>
</select></div>
</li>
<li id="field_16_298" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_298">Post Code</label>
<div class="ginput_container ginput_container_text"><input name="input_298" id="input_16_298" type="text" value="" class="medium" tabindex="41" aria-invalid="false"></div>
</li>
<li id="field_16_94" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_94">Driver's Licence No.</label>
<div class="ginput_container ginput_container_text"><input name="input_94" id="input_16_94" type="text" value="" class="medium" tabindex="42" aria-invalid="false"></div>
</li>
<li id="field_16_110" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_110">Date of Birth</label>
<div class="ginput_container ginput_container_text"><input name="input_110" id="input_16_110" type="text" value="" class="medium" tabindex="43" aria-invalid="false"></div>
</li>
<li id="field_16_125" class="gfield gf_left_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Home Ownership Status</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_125">
<li class="gchoice_16_125_0"><input name="input_125" type="radio" value="Own" id="choice_16_125_0" tabindex="44"><label for="choice_16_125_0" id="label_16_125_0">Own</label></li>
<li class="gchoice_16_125_1"><input name="input_125" type="radio" value="Rent" id="choice_16_125_1" tabindex="45"><label for="choice_16_125_1" id="label_16_125_1">Rent</label></li>
<li class="gchoice_16_125_2"><input name="input_125" type="radio" value="gf_other_choice" id="choice_16_125_2" tabindex="46" onfocus="jQuery(this).next('input').focus();"><input id="input_16_125_other" name="input_125_other" type="text"
value="Other" aria-label="Other" onfocus="jQuery(this).prev("input")[0].click(); if(jQuery(this).val() == "Other") { jQuery(this).val(""); }"
onblur="if(jQuery(this).val().replace(" ", "") == "") { jQuery(this).val("Other"); }" tabindex="46"></li>
</ul>
</div>
</li>
<li id="field_16_126" class="gfield gf_right_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Residency Status</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_126">
<li class="gchoice_16_126_0"><input name="input_126" type="radio" value="Australian Citizen" id="choice_16_126_0" tabindex="47"><label for="choice_16_126_0" id="label_16_126_0">Australian Citizen</label></li>
<li class="gchoice_16_126_1"><input name="input_126" type="radio" value="Permanent Resident" id="choice_16_126_1" tabindex="48"><label for="choice_16_126_1" id="label_16_126_1">Permanent Resident</label></li>
<li class="gchoice_16_126_2"><input name="input_126" type="radio" value="gf_other_choice" id="choice_16_126_2" tabindex="49" onfocus="jQuery(this).next('input').focus();"><input id="input_16_126_other" name="input_126_other" type="text"
value="Other" aria-label="Other" onfocus="jQuery(this).prev("input")[0].click(); if(jQuery(this).val() == "Other") { jQuery(this).val(""); }"
onblur="if(jQuery(this).val().replace(" ", "") == "") { jQuery(this).val("Other"); }" tabindex="49"></li>
</ul>
</div>
</li>
<li id="field_16_127" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_127">Years at Home Address</label>
<div class="ginput_container ginput_container_text"><input name="input_127" id="input_16_127" type="text" value="" class="medium" tabindex="50" aria-invalid="false"></div>
</li>
<li id="field_16_128" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_128">Business Ownership %</label>
<div class="ginput_container ginput_container_text"><input name="input_128" id="input_16_128" type="text" value="" class="medium" tabindex="51" aria-invalid="false"></div>
</li>
<li id="field_16_101" class="gfield gf_list_inline hide_on_pdf expand_out field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Add Applicant 3?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_101">
<li class="gchoice_16_101_0"><input name="input_101" type="radio" value="No" checked="checked" id="choice_16_101_0" tabindex="52" onclick="gf_apply_rules(16,[113,113,234,234]);" onkeypress="gf_apply_rules(16,[113,113,234,234]);"><label
for="choice_16_101_0" id="label_16_101_0">No</label></li>
<li class="gchoice_16_101_1"><input name="input_101" type="radio" value="Yes" id="choice_16_101_1" tabindex="53" onclick="gf_apply_rules(16,[113,113,234,234]);" onkeypress="gf_apply_rules(16,[113,113,234,234]);"><label
for="choice_16_101_1" id="label_16_101_1">Yes</label></li>
</ul>
</div>
</li>
<li id="field_16_113" class="gfield gsection main_section_subsection field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h2 class="gsection_title"></h2>
</li>
<li id="field_16_209" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h4>Applicant 3</h4>
</li>
<li id="field_16_119" class="gfield gf_list_3col field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Capacity of Applicant</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_119">
<li class="gchoice_16_119_0"><input name="input_119" type="radio" value="Borrower" id="choice_16_119_0" tabindex="54"><label for="choice_16_119_0" id="label_16_119_0">Borrower</label></li>
<li class="gchoice_16_119_1"><input name="input_119" type="radio" value="Guarantor" id="choice_16_119_1" tabindex="55"><label for="choice_16_119_1" id="label_16_119_1">Guarantor</label></li>
<li class="gchoice_16_119_2"><input name="input_119" type="radio" value="Joint Applicant" id="choice_16_119_2" tabindex="56"><label for="choice_16_119_2" id="label_16_119_2">Joint Applicant</label></li>
</ul>
</div>
</li>
<li id="field_16_118" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_118">Full Name</label>
<div class="ginput_container ginput_container_text"><input name="input_118" id="input_16_118" type="text" value="" class="medium" tabindex="57" aria-invalid="false"></div>
</li>
<li id="field_16_117" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_117">Mobile / Telephone</label>
<div class="ginput_container ginput_container_text"><input name="input_117" id="input_16_117" type="text" value="" class="medium" tabindex="58" aria-invalid="false"></div>
</li>
<li id="field_16_140" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_140">Email</label>
<div class="ginput_container ginput_container_email">
<input name="input_140" id="input_16_140" type="text" value="" class="medium" tabindex="59" aria-invalid="false">
</div>
</li>
<li id="field_16_141" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_141">Occupation / Position</label>
<div class="ginput_container ginput_container_text"><input name="input_141" id="input_16_141" type="text" value="" class="medium" tabindex="60" aria-invalid="false"></div>
</li>
<li id="field_16_302" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_302">Home Street Address</label>
<div class="ginput_container ginput_container_text"><input name="input_302" id="input_16_302" type="text" value="" class="medium" tabindex="61" aria-invalid="false"></div>
</li>
<li id="field_16_301" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_301">Suburb</label>
<div class="ginput_container ginput_container_text"><input name="input_301" id="input_16_301" type="text" value="" class="medium" tabindex="62" aria-invalid="false"></div>
</li>
<li id="field_16_300" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_300">State</label>
<div class="ginput_container ginput_container_select"><select name="input_300" id="input_16_300" class="medium gfield_select" aria-invalid="false">
<option value=""></option>
<option value="NSW">NSW</option>
<option value="VIC">VIC</option>
<option value="ACT">ACT</option>
<option value="WA">WA</option>
<option value="TAS">TAS</option>
<option value="NT">NT</option>
</select></div>
</li>
<li id="field_16_299" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_299">Post Code</label>
<div class="ginput_container ginput_container_text"><input name="input_299" id="input_16_299" type="text" value="" class="medium" tabindex="64" aria-invalid="false"></div>
</li>
<li id="field_16_115" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_115">Driver's Licence No.</label>
<div class="ginput_container ginput_container_text"><input name="input_115" id="input_16_115" type="text" value="" class="medium" tabindex="65" aria-invalid="false"></div>
</li>
<li id="field_16_114" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_114">Date of Birth</label>
<div class="ginput_container ginput_container_text"><input name="input_114" id="input_16_114" type="text" value="" class="medium" tabindex="66" aria-invalid="false"></div>
</li>
<li id="field_16_132" class="gfield gf_left_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Home Ownership Status</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_132">
<li class="gchoice_16_132_0"><input name="input_132" type="radio" value="Own" id="choice_16_132_0" tabindex="67"><label for="choice_16_132_0" id="label_16_132_0">Own</label></li>
<li class="gchoice_16_132_1"><input name="input_132" type="radio" value="Rent" id="choice_16_132_1" tabindex="68"><label for="choice_16_132_1" id="label_16_132_1">Rent</label></li>
<li class="gchoice_16_132_2"><input name="input_132" type="radio" value="gf_other_choice" id="choice_16_132_2" tabindex="69" onfocus="jQuery(this).next('input').focus();"><input id="input_16_132_other" name="input_132_other" type="text"
value="Other" aria-label="Other" onfocus="jQuery(this).prev("input")[0].click(); if(jQuery(this).val() == "Other") { jQuery(this).val(""); }"
onblur="if(jQuery(this).val().replace(" ", "") == "") { jQuery(this).val("Other"); }" tabindex="69"></li>
</ul>
</div>
</li>
<li id="field_16_131" class="gfield gf_right_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Residency Status</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_131">
<li class="gchoice_16_131_0"><input name="input_131" type="radio" value="Australian Citizen" id="choice_16_131_0" tabindex="70"><label for="choice_16_131_0" id="label_16_131_0">Australian Citizen</label></li>
<li class="gchoice_16_131_1"><input name="input_131" type="radio" value="Permanent Resident" id="choice_16_131_1" tabindex="71"><label for="choice_16_131_1" id="label_16_131_1">Permanent Resident</label></li>
<li class="gchoice_16_131_2"><input name="input_131" type="radio" value="gf_other_choice" id="choice_16_131_2" tabindex="72" onfocus="jQuery(this).next('input').focus();"><input id="input_16_131_other" name="input_131_other" type="text"
value="Other" aria-label="Other" onfocus="jQuery(this).prev("input")[0].click(); if(jQuery(this).val() == "Other") { jQuery(this).val(""); }"
onblur="if(jQuery(this).val().replace(" ", "") == "") { jQuery(this).val("Other"); }" tabindex="72"></li>
</ul>
</div>
</li>
<li id="field_16_130" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_130">Years at Home Address</label>
<div class="ginput_container ginput_container_text"><input name="input_130" id="input_16_130" type="text" value="" class="medium" tabindex="73" aria-invalid="false"></div>
</li>
<li id="field_16_129" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_129">Business Ownership %</label>
<div class="ginput_container ginput_container_text"><input name="input_129" id="input_16_129" type="text" value="" class="medium" tabindex="74" aria-invalid="false"></div>
</li>
</div>
<li id="field_16_29" class="gfield gsection main_section field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title">Business Details <span class="m_expand"><span class="m_expand_text">EXPAND <i class="fa fa-chevron-circle-right"></i></span><span class="m_collapse_text"></span></span></h2>
</li>
<div class="m_section" style="display: none;">
<li id="field_16_210" class="gfield gf_list_4col field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Type of Entity</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_210">
<li class="gchoice_16_210_0"><input name="input_210" type="radio" value="Company" id="choice_16_210_0" tabindex="75"><label for="choice_16_210_0" id="label_16_210_0">Company</label></li>
<li class="gchoice_16_210_1"><input name="input_210" type="radio" value="Partnership" id="choice_16_210_1" tabindex="76"><label for="choice_16_210_1" id="label_16_210_1">Partnership</label></li>
<li class="gchoice_16_210_2"><input name="input_210" type="radio" value="Sole Trader" id="choice_16_210_2" tabindex="77"><label for="choice_16_210_2" id="label_16_210_2">Sole Trader</label></li>
<li class="gchoice_16_210_3"><input name="input_210" type="radio" value="gf_other_choice" id="choice_16_210_3" tabindex="78" onfocus="jQuery(this).next('input').focus();"><input id="input_16_210_other" name="input_210_other" type="text"
value="Other" aria-label="Other" onfocus="jQuery(this).prev("input")[0].click(); if(jQuery(this).val() == "Other") { jQuery(this).val(""); }"
onblur="if(jQuery(this).val().replace(" ", "") == "") { jQuery(this).val("Other"); }" tabindex="78"></li>
</ul>
</div>
</li>
<li id="field_16_31" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_31">Company / Trust Name</label>
<div class="ginput_container ginput_container_text"><input name="input_31" id="input_16_31" type="text" value="" class="medium" tabindex="79" aria-invalid="false"></div>
</li>
<li id="field_16_32" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_32">ABN / ACN</label>
<div class="ginput_container ginput_container_text"><input name="input_32" id="input_16_32" type="text" value="" class="medium" tabindex="80" aria-invalid="false"></div>
</li>
<li id="field_16_303" class="gfield gf_left_half copy-303-to-327 gwcopy field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_303">Trading Street Address</label>
<div class="ginput_container ginput_container_text"><input name="input_303" id="input_16_303" type="text" value="" class="medium" tabindex="81" aria-invalid="false"></div>
</li>
<li id="field_16_304" class="gfield gf_right_half copy-304-to-328 gwcopy field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_304">Suburb</label>
<div class="ginput_container ginput_container_text"><input name="input_304" id="input_16_304" type="text" value="" class="medium" tabindex="82" aria-invalid="false"></div>
</li>
<li id="field_16_305" class="gfield gf_left_half copy-305-to-329 gwcopy field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_305">State</label>
<div class="ginput_container ginput_container_select"><select name="input_305" id="input_16_305" class="medium gfield_select" tabindex="83" aria-invalid="false">
<option value=""></option>
<option value="NSW">NSW</option>
<option value="VIC">VIC</option>
<option value="ACT">ACT</option>
<option value="WA">WA</option>
<option value="TAS">TAS</option>
<option value="NT">NT</option>
</select></div>
</li>
<li id="field_16_306" class="gfield gf_right_half copy-306-to-330 gwcopy field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_306">Post Code</label>
<div class="ginput_container ginput_container_text"><input name="input_306" id="input_16_306" type="text" value="" class="medium" tabindex="84" aria-invalid="false"></div>
</li>
<li id="field_16_212" class="gfield gf_list_inline expand_out field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Postal Address different to Trading Address?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_212">
<li class="gchoice_16_212_0"><input name="input_212" type="radio" value="No" checked="checked" id="choice_16_212_0" tabindex="85" onclick="gf_apply_rules(16,[307,308,309,310]);" onkeypress="gf_apply_rules(16,[307,308,309,310]);"><label
for="choice_16_212_0" id="label_16_212_0">No</label></li>
<li class="gchoice_16_212_1"><input name="input_212" type="radio" value="Yes" id="choice_16_212_1" tabindex="86" onclick="gf_apply_rules(16,[307,308,309,310]);" onkeypress="gf_apply_rules(16,[307,308,309,310]);"><label
for="choice_16_212_1" id="label_16_212_1">Yes</label></li>
</ul>
</div>
</li>
<li id="field_16_307" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_307">Postal Street Address</label>
<div class="ginput_container ginput_container_text"><input name="input_307" id="input_16_307" type="text" value="" class="medium" tabindex="87" aria-invalid="false"></div>
</li>
<li id="field_16_308" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_308">Suburb</label>
<div class="ginput_container ginput_container_text"><input name="input_308" id="input_16_308" type="text" value="" class="medium" tabindex="88" aria-invalid="false"></div>
</li>
<li id="field_16_309" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_309">State</label>
<div class="ginput_container ginput_container_select"><select name="input_309" id="input_16_309" class="medium gfield_select" aria-invalid="false">
<option value=""></option>
<option value="NSW">NSW</option>
<option value="VIC">VIC</option>
<option value="ACT">ACT</option>
<option value="WA">WA</option>
<option value="TAS">TAS</option>
<option value="NT">NT</option>
</select></div>
</li>
<li id="field_16_310" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_310">Post Code</label>
<div class="ginput_container ginput_container_text"><input name="input_310" id="input_16_310" type="text" value="" class="medium" tabindex="90" aria-invalid="false"></div>
</li>
<li id="field_16_37" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_37">Principle Business Activity</label>
<div class="ginput_container ginput_container_text"><input name="input_37" id="input_16_37" type="text" value="" class="medium" tabindex="91" aria-invalid="false"></div>
</li>
<li id="field_16_84" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_84">Business Start Date</label>
<div class="ginput_container ginput_container_text"><input name="input_84" id="input_16_84" type="text" value="" class="medium" tabindex="92" aria-invalid="false"></div>
</li>
<li id="field_16_217" class="gfield gf_left_half copy-217-to-237 gwcopy field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_217">Owner's Name</label>
<div class="ginput_container ginput_container_text"><input name="input_217" id="input_16_217" type="text" value="" class="medium" tabindex="93" aria-invalid="false"></div>
</li>
<li id="field_16_35" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_35">Phone Number</label>
<div class="ginput_container ginput_container_text"><input name="input_35" id="input_16_35" type="text" value="" class="medium" tabindex="94" aria-invalid="false"></div>
</li>
<li id="field_16_214" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_214">Email</label>
<div class="ginput_container ginput_container_email">
<input name="input_214" id="input_16_214" type="text" value="" class="medium" tabindex="95" aria-invalid="false">
</div>
</li>
<li id="field_16_211" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_211">Website</label>
<div class="ginput_container ginput_container_text"><input name="input_211" id="input_16_211" type="text" value="" class="medium" tabindex="96" aria-invalid="false"></div>
</li>
<li id="field_16_215" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_215">Monthly Rent $</label>
<div class="ginput_container ginput_container_text"><input name="input_215" id="input_16_215" type="text" value="" class="medium" tabindex="97" aria-invalid="false"></div>
</li>
<li id="field_16_216" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_216">Lease End Date</label>
<div class="ginput_container ginput_container_text"><input name="input_216" id="input_16_216" type="text" value="" class="medium" tabindex="98" aria-invalid="false"></div>
</li>
</div>
<li id="field_16_52" class="gfield gsection main_section field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title">Details of Loan Required <span class="m_expand"><span class="m_expand_text">EXPAND <i class="fa fa-chevron-circle-right"></i></span><span class="m_collapse_text"></span></span></h2>
</li>
<div class="m_section" style="display: none;">
<li id="field_16_331" class="gfield gf_left_third field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_331">Loan Amount Required $</label>
<div class="ginput_container ginput_container_text"><input name="input_331" id="input_16_331" type="text" value="" class="medium" tabindex="99" aria-invalid="false"></div>
</li>
<li id="field_16_54" class="gfield gf_middle_third field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_54">Term</label>
<div class="ginput_container ginput_container_text"><input name="input_54" id="input_16_54" type="text" value="" class="medium" tabindex="100" aria-invalid="false"></div>
<div class="gfield_description">(Months)</div>
</li>
<li id="field_16_143" class="gfield gf_right_third field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_143">Settlement Date</label>
<div class="ginput_container ginput_container_text"><input name="input_143" id="input_16_143" type="text" value="" class="medium" tabindex="101" aria-invalid="false"></div>
<div class="gfield_description">If known.</div>
</li>
<li id="field_16_144" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_144">Loan Purpose</label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_144" id="input_16_144" class="textarea medium" tabindex="102" aria-invalid="false" rows="10" cols="50"></textarea></div>
</li>
<li id="field_16_145" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_145">Loan Repayment Strategy</label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_145" id="input_16_145" class="textarea medium" tabindex="103" aria-invalid="false" rows="10" cols="50"></textarea></div>
<div class="gfield_description">(e.g. refinance, sale of property etc)</div>
</li>
</div>
<li id="field_16_57" class="gfield gsection main_section field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title">Security Offered for the Loan <span class="m_expand"><span class="m_expand_text">EXPAND <i class="fa fa-chevron-circle-right"></i></span><span class="m_collapse_text"></span></span></h2>
</li>
<div class="m_section" style="display: none;">
<li id="field_16_58" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible">
<h4>Property 1</h4>
</li>
<li id="field_16_311" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_311">Property Street Address</label>
<div class="ginput_container ginput_container_text"><input name="input_311" id="input_16_311" type="text" value="" class="medium" tabindex="104" aria-invalid="false"></div>
</li>
<li id="field_16_312" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_312">Suburb</label>
<div class="ginput_container ginput_container_text"><input name="input_312" id="input_16_312" type="text" value="" class="medium" tabindex="105" aria-invalid="false"></div>
</li>
<li id="field_16_313" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_313">State</label>
<div class="ginput_container ginput_container_select"><select name="input_313" id="input_16_313" class="medium gfield_select" tabindex="106" aria-invalid="false">
<option value=""></option>
<option value="NSW">NSW</option>
<option value="VIC">VIC</option>
<option value="ACT">ACT</option>
<option value="WA">WA</option>
<option value="TAS">TAS</option>
<option value="NT">NT</option>
</select></div>
</li>
<li id="field_16_314" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_314">Post Code</label>
<div class="ginput_container ginput_container_text"><input name="input_314" id="input_16_314" type="text" value="" class="medium" tabindex="107" aria-invalid="false"></div>
</li>
<li id="field_16_62" class="gfield gf_left_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Ownership of Property</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_62">
<li class="gchoice_16_62_0"><input name="input_62" type="radio" value="Being Purchased" id="choice_16_62_0" tabindex="108"><label for="choice_16_62_0" id="label_16_62_0">Being Purchased</label></li>
<li class="gchoice_16_62_1"><input name="input_62" type="radio" value="Already Owned" id="choice_16_62_1" tabindex="109"><label for="choice_16_62_1" id="label_16_62_1">Already Owned</label></li>
</ul>
</div>
</li>
<li id="field_16_147" class="gfield gf_right_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Type of Property</label>
<div class="ginput_container ginput_container_checkbox">
<ul class="gfield_checkbox" id="input_16_147">
<li class="gchoice_16_147_1">
<input name="input_147.1" type="checkbox" value="Residential" id="choice_16_147_1" tabindex="110">
<label for="choice_16_147_1" id="label_16_147_1">Residential</label>
</li>
<li class="gchoice_16_147_2">
<input name="input_147.2" type="checkbox" value="Commercial" id="choice_16_147_2" tabindex="111">
<label for="choice_16_147_2" id="label_16_147_2">Commercial</label>
</li>
<li class="gchoice_16_147_3">
<input name="input_147.3" type="checkbox" value="Vacant Land" id="choice_16_147_3" tabindex="112">
<label for="choice_16_147_3" id="label_16_147_3">Vacant Land</label>
</li>
</ul>
</div>
</li>
<li id="field_16_63" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_63">Estimated Value or Purchase Price $</label>
<div class="ginput_container ginput_container_text"><input name="input_63" id="input_16_63" type="text" value="" class="medium" tabindex="113" aria-invalid="false"></div>
</li>
<li id="field_16_64" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_64">Rental Value Per Week $</label>
<div class="ginput_container ginput_container_text"><input name="input_64" id="input_16_64" type="text" value="" class="medium" tabindex="114" aria-invalid="false"></div>
<div class="gfield_description">(if applicable)</div>
</li>
<li id="field_16_148" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_148">Lender</label>
<div class="ginput_container ginput_container_text"><input name="input_148" id="input_16_148" type="text" value="" class="medium" tabindex="115" aria-invalid="false"></div>
</li>
<li id="field_16_243" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_243">Current Debt $</label>
<div class="ginput_container ginput_container_text"><input name="input_243" id="input_16_243" type="text" value="" class="medium" tabindex="116" aria-invalid="false"></div>
</li>
<li id="field_16_151" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_151">Notes or Comments?</label>
<div class="ginput_container ginput_container_text"><input name="input_151" id="input_16_151" type="text" value="" class="medium" tabindex="117" aria-invalid="false"></div>
</li>
<li id="field_16_79" class="gfield gf_list_inline hide_on_pdf expand_out field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Add Security Property 2?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_79">
<li class="gchoice_16_79_0"><input name="input_79" type="radio" value="No" checked="checked" id="choice_16_79_0" tabindex="118" onclick="gf_apply_rules(16,[288,288]);" onkeypress="gf_apply_rules(16,[288,288]);"><label
for="choice_16_79_0" id="label_16_79_0">No</label></li>
<li class="gchoice_16_79_1"><input name="input_79" type="radio" value="Yes" id="choice_16_79_1" tabindex="119" onclick="gf_apply_rules(16,[288,288]);" onkeypress="gf_apply_rules(16,[288,288]);"><label for="choice_16_79_1"
id="label_16_79_1">Yes</label></li>
</ul>
</div>
</li>
<li id="field_16_288" class="gfield gsection main_section_subsection field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h2 class="gsection_title"></h2>
</li>
<li id="field_16_159" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h4>Property 2</h4>
</li>
<li id="field_16_315" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_315">Property Street Address</label>
<div class="ginput_container ginput_container_text"><input name="input_315" id="input_16_315" type="text" value="" class="medium" tabindex="120" aria-invalid="false"></div>
</li>
<li id="field_16_316" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_316">Suburb</label>
<div class="ginput_container ginput_container_text"><input name="input_316" id="input_16_316" type="text" value="" class="medium" tabindex="121" aria-invalid="false"></div>
</li>
<li id="field_16_317" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_317">State</label>
<div class="ginput_container ginput_container_select"><select name="input_317" id="input_16_317" class="medium gfield_select" aria-invalid="false">
<option value=""></option>
<option value="NSW">NSW</option>
<option value="VIC">VIC</option>
<option value="ACT">ACT</option>
<option value="WA">WA</option>
<option value="TAS">TAS</option>
<option value="NT">NT</option>
</select></div>
</li>
<li id="field_16_318" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_318">Post Code</label>
<div class="ginput_container ginput_container_text"><input name="input_318" id="input_16_318" type="text" value="" class="medium" tabindex="123" aria-invalid="false"></div>
</li>
<li id="field_16_157" class="gfield gf_left_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Ownership of Property</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_157">
<li class="gchoice_16_157_0"><input name="input_157" type="radio" value="Being Purchased" id="choice_16_157_0" tabindex="124"><label for="choice_16_157_0" id="label_16_157_0">Being Purchased</label></li>
<li class="gchoice_16_157_1"><input name="input_157" type="radio" value="Already Owned" id="choice_16_157_1" tabindex="125"><label for="choice_16_157_1" id="label_16_157_1">Already Owned</label></li>
</ul>
</div>
</li>
<li id="field_16_156" class="gfield gf_right_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Type of Property</label>
<div class="ginput_container ginput_container_checkbox">
<ul class="gfield_checkbox" id="input_16_156">
<li class="gchoice_16_156_1">
<input name="input_156.1" type="checkbox" value="Residential" id="choice_16_156_1" tabindex="126">
<label for="choice_16_156_1" id="label_16_156_1">Residential</label>
</li>
<li class="gchoice_16_156_2">
<input name="input_156.2" type="checkbox" value="Commercial" id="choice_16_156_2" tabindex="127">
<label for="choice_16_156_2" id="label_16_156_2">Commercial</label>
</li>
<li class="gchoice_16_156_3">
<input name="input_156.3" type="checkbox" value="Vacant Land" id="choice_16_156_3" tabindex="128">
<label for="choice_16_156_3" id="label_16_156_3">Vacant Land</label>
</li>
</ul>
</div>
</li>
<li id="field_16_155" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_155">Estimated Value or Purchase Price $</label>
<div class="ginput_container ginput_container_text"><input name="input_155" id="input_16_155" type="text" value="" class="medium" tabindex="129" aria-invalid="false"></div>
</li>
<li id="field_16_154" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_154">Rental Value Per Week $</label>
<div class="ginput_container ginput_container_text"><input name="input_154" id="input_16_154" type="text" value="" class="medium" tabindex="130" aria-invalid="false"></div>
<div class="gfield_description">(if applicable)</div>
</li>
<li id="field_16_153" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_153">Lender</label>
<div class="ginput_container ginput_container_text"><input name="input_153" id="input_16_153" type="text" value="" class="medium" tabindex="131" aria-invalid="false"></div>
</li>
<li id="field_16_244" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_244">Current Debt $</label>
<div class="ginput_container ginput_container_text"><input name="input_244" id="input_16_244" type="text" value="" class="medium" tabindex="132" aria-invalid="false"></div>
</li>
<li id="field_16_152" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_152">Notes or Comments?</label>
<div class="ginput_container ginput_container_text"><input name="input_152" id="input_16_152" type="text" value="" class="medium" tabindex="133" aria-invalid="false"></div>
</li>
<li id="field_16_150" class="gfield gf_list_inline hide_on_pdf expand_out field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Add Security Property 3?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_150">
<li class="gchoice_16_150_0"><input name="input_150" type="radio" value="No" checked="checked" id="choice_16_150_0" tabindex="134" onclick="gf_apply_rules(16,[287,287]);" onkeypress="gf_apply_rules(16,[287,287]);"><label
for="choice_16_150_0" id="label_16_150_0">No</label></li>
<li class="gchoice_16_150_1"><input name="input_150" type="radio" value="Yes" id="choice_16_150_1" tabindex="135" onclick="gf_apply_rules(16,[287,287]);" onkeypress="gf_apply_rules(16,[287,287]);"><label for="choice_16_150_1"
id="label_16_150_1">Yes</label></li>
</ul>
</div>
</li>
<li id="field_16_287" class="gfield gsection main_section_subsection field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h2 class="gsection_title"></h2>
</li>
<li id="field_16_169" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h4>Property 3</h4>
</li>
<li id="field_16_319" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_319">Property Street Address</label>
<div class="ginput_container ginput_container_text"><input name="input_319" id="input_16_319" type="text" value="" class="medium" tabindex="136" aria-invalid="false"></div>
</li>
<li id="field_16_320" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_320">Suburb</label>
<div class="ginput_container ginput_container_text"><input name="input_320" id="input_16_320" type="text" value="" class="medium" tabindex="137" aria-invalid="false"></div>
</li>
<li id="field_16_321" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_321">State</label>
<div class="ginput_container ginput_container_select"><select name="input_321" id="input_16_321" class="medium gfield_select" aria-invalid="false">
<option value=""></option>
<option value="NSW">NSW</option>
<option value="VIC">VIC</option>
<option value="ACT">ACT</option>
<option value="WA">WA</option>
<option value="TAS">TAS</option>
<option value="NT">NT</option>
</select></div>
</li>
<li id="field_16_322" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_322">Post Code</label>
<div class="ginput_container ginput_container_text"><input name="input_322" id="input_16_322" type="text" value="" class="medium" tabindex="139" aria-invalid="false"></div>
</li>
<li id="field_16_167" class="gfield gf_left_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Ownership of Property</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_167">
<li class="gchoice_16_167_0"><input name="input_167" type="radio" value="Being Purchased" id="choice_16_167_0" tabindex="140"><label for="choice_16_167_0" id="label_16_167_0">Being Purchased</label></li>
<li class="gchoice_16_167_1"><input name="input_167" type="radio" value="Already Owned" id="choice_16_167_1" tabindex="141"><label for="choice_16_167_1" id="label_16_167_1">Already Owned</label></li>
</ul>
</div>
</li>
<li id="field_16_166" class="gfield gf_right_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Type of Property</label>
<div class="ginput_container ginput_container_checkbox">
<ul class="gfield_checkbox" id="input_16_166">
<li class="gchoice_16_166_1">
<input name="input_166.1" type="checkbox" value="Residential" id="choice_16_166_1" tabindex="142">
<label for="choice_16_166_1" id="label_16_166_1">Residential</label>
</li>
<li class="gchoice_16_166_2">
<input name="input_166.2" type="checkbox" value="Commercial" id="choice_16_166_2" tabindex="143">
<label for="choice_16_166_2" id="label_16_166_2">Commercial</label>
</li>
<li class="gchoice_16_166_3">
<input name="input_166.3" type="checkbox" value="Vacant Land" id="choice_16_166_3" tabindex="144">
<label for="choice_16_166_3" id="label_16_166_3">Vacant Land</label>
</li>
</ul>
</div>
</li>
<li id="field_16_165" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_165">Estimated Value or Purchase Price $</label>
<div class="ginput_container ginput_container_text"><input name="input_165" id="input_16_165" type="text" value="" class="medium" tabindex="145" aria-invalid="false"></div>
</li>
<li id="field_16_164" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_164">Rental Value Per Week $</label>
<div class="ginput_container ginput_container_text"><input name="input_164" id="input_16_164" type="text" value="" class="medium" tabindex="146" aria-invalid="false"></div>
<div class="gfield_description">(if applicable)</div>
</li>
<li id="field_16_163" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_163">Lender</label>
<div class="ginput_container ginput_container_text"><input name="input_163" id="input_16_163" type="text" value="" class="medium" tabindex="147" aria-invalid="false"></div>
</li>
<li id="field_16_245" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_245">Current Debt $</label>
<div class="ginput_container ginput_container_text"><input name="input_245" id="input_16_245" type="text" value="" class="medium" tabindex="148" aria-invalid="false"></div>
</li>
<li id="field_16_162" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_162">Notes or Comments?</label>
<div class="ginput_container ginput_container_text"><input name="input_162" id="input_16_162" type="text" value="" class="medium" tabindex="149" aria-invalid="false"></div>
</li>
<li id="field_16_161" class="gfield gf_list_inline hide_on_pdf expand_out field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Add Security Property 4?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_161">
<li class="gchoice_16_161_0"><input name="input_161" type="radio" value="No" checked="checked" id="choice_16_161_0" tabindex="150" onclick="gf_apply_rules(16,[286,286]);" onkeypress="gf_apply_rules(16,[286,286]);"><label
for="choice_16_161_0" id="label_16_161_0">No</label></li>
<li class="gchoice_16_161_1"><input name="input_161" type="radio" value="Yes" id="choice_16_161_1" tabindex="151" onclick="gf_apply_rules(16,[286,286]);" onkeypress="gf_apply_rules(16,[286,286]);"><label for="choice_16_161_1"
id="label_16_161_1">Yes</label></li>
</ul>
</div>
</li>
<li id="field_16_286" class="gfield gsection main_section_subsection field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h2 class="gsection_title"></h2>
</li>
<li id="field_16_178" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h4>Property 4</h4>
</li>
<li id="field_16_323" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_323">Property Street Address</label>
<div class="ginput_container ginput_container_text"><input name="input_323" id="input_16_323" type="text" value="" class="medium" tabindex="152" aria-invalid="false"></div>
</li>
<li id="field_16_324" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_324">Suburb</label>
<div class="ginput_container ginput_container_text"><input name="input_324" id="input_16_324" type="text" value="" class="medium" tabindex="153" aria-invalid="false"></div>
</li>
<li id="field_16_325" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_325">State</label>
<div class="ginput_container ginput_container_select"><select name="input_325" id="input_16_325" class="medium gfield_select" aria-invalid="false">
<option value=""></option>
<option value="NSW">NSW</option>
<option value="VIC">VIC</option>
<option value="ACT">ACT</option>
<option value="WA">WA</option>
<option value="TAS">TAS</option>
<option value="NT">NT</option>
</select></div>
</li>
<li id="field_16_326" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_326">Post Code</label>
<div class="ginput_container ginput_container_text"><input name="input_326" id="input_16_326" type="text" value="" class="medium" tabindex="155" aria-invalid="false"></div>
</li>
<li id="field_16_176" class="gfield gf_left_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Ownership of Property</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_176">
<li class="gchoice_16_176_0"><input name="input_176" type="radio" value="Being Purchased" id="choice_16_176_0" tabindex="156"><label for="choice_16_176_0" id="label_16_176_0">Being Purchased</label></li>
<li class="gchoice_16_176_1"><input name="input_176" type="radio" value="Already Owned" id="choice_16_176_1" tabindex="157"><label for="choice_16_176_1" id="label_16_176_1">Already Owned</label></li>
</ul>
</div>
</li>
<li id="field_16_175" class="gfield gf_right_half gf_inline_list field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Type of Property</label>
<div class="ginput_container ginput_container_checkbox">
<ul class="gfield_checkbox" id="input_16_175">
<li class="gchoice_16_175_1">
<input name="input_175.1" type="checkbox" value="Residential" id="choice_16_175_1" tabindex="158">
<label for="choice_16_175_1" id="label_16_175_1">Residential</label>
</li>
<li class="gchoice_16_175_2">
<input name="input_175.2" type="checkbox" value="Commercial" id="choice_16_175_2" tabindex="159">
<label for="choice_16_175_2" id="label_16_175_2">Commercial</label>
</li>
<li class="gchoice_16_175_3">
<input name="input_175.3" type="checkbox" value="Vacant Land" id="choice_16_175_3" tabindex="160">
<label for="choice_16_175_3" id="label_16_175_3">Vacant Land</label>
</li>
</ul>
</div>
</li>
<li id="field_16_174" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_174">Estimated Value or Purchase Price $</label>
<div class="ginput_container ginput_container_text"><input name="input_174" id="input_16_174" type="text" value="" class="medium" tabindex="161" aria-invalid="false"></div>
</li>
<li id="field_16_173" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_173">Rental Value Per Week $</label>
<div class="ginput_container ginput_container_text"><input name="input_173" id="input_16_173" type="text" value="" class="medium" tabindex="162" aria-invalid="false"></div>
<div class="gfield_description">(if applicable)</div>
</li>
<li id="field_16_172" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_172">Lender</label>
<div class="ginput_container ginput_container_text"><input name="input_172" id="input_16_172" type="text" value="" class="medium" tabindex="163" aria-invalid="false"></div>
</li>
<li id="field_16_246" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_246">Current Debt $</label>
<div class="ginput_container ginput_container_text"><input name="input_246" id="input_16_246" type="text" value="" class="medium" tabindex="164" aria-invalid="false"></div>
</li>
<li id="field_16_171" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_171">Notes or Comments?</label>
<div class="ginput_container ginput_container_text"><input name="input_171" id="input_16_171" type="text" value="" class="medium" tabindex="165" aria-invalid="false"></div>
</li>
</div>
<li id="field_16_179" class="gfield gsection main_section field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title">Additional Assets and Liabilities <span class="m_expand"><span class="m_expand_text">EXPAND <i class="fa fa-chevron-circle-right"></i></span><span class="m_collapse_text"></span></span></h2>
</li>
<div class="m_section" style="display: none;">
<li id="field_16_185" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible">
<h4>Asset / Liability 1</h4>
</li>
<li id="field_16_334" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Type of Asset 1</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_334">
<li class="gchoice_16_334_0"><input name="input_334" type="radio" value="Property" id="choice_16_334_0" tabindex="166" onclick="gf_apply_rules(16,[335,180,252,251,250,249,248]);"
onkeypress="gf_apply_rules(16,[335,180,252,251,250,249,248]);"><label for="choice_16_334_0" id="label_16_334_0">Property</label></li>
<li class="gchoice_16_334_1"><input name="input_334" type="radio" value="Vehicle or Machinery" id="choice_16_334_1" tabindex="167" onclick="gf_apply_rules(16,[335,180,252,251,250,249,248]);"
onkeypress="gf_apply_rules(16,[335,180,252,251,250,249,248]);"><label for="choice_16_334_1" id="label_16_334_1">Vehicle or Machinery</label></li>
</ul>
</div>
</li>
<li id="field_16_335" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Property Type</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_335">
<li class="gchoice_16_335_0"><input name="input_335" type="radio" value="Residential" id="choice_16_335_0" tabindex="168"><label for="choice_16_335_0" id="label_16_335_0">Residential</label></li>
<li class="gchoice_16_335_1"><input name="input_335" type="radio" value="Commercial" id="choice_16_335_1" tabindex="169"><label for="choice_16_335_1" id="label_16_335_1">Commercial</label></li>
<li class="gchoice_16_335_2"><input name="input_335" type="radio" value="Rural" id="choice_16_335_2" tabindex="170"><label for="choice_16_335_2" id="label_16_335_2">Rural</label></li>
</ul>
</div>
</li>
<li id="field_16_190" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_190">Details</label>
<div class="ginput_container ginput_container_text"><input name="input_190" id="input_16_190" type="text" value="" class="medium" tabindex="171" aria-invalid="false"></div>
</li>
<li id="field_16_182" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_182">Lender</label>
<div class="ginput_container ginput_container_text"><input name="input_182" id="input_16_182" type="text" value="" class="medium" tabindex="172" aria-invalid="false"></div>
</li>
<li id="field_16_183" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_183">Current Debt $</label>
<div class="ginput_container ginput_container_text"><input name="input_183" id="input_16_183" type="text" value="" class="medium" tabindex="173" aria-invalid="false"></div>
</li>
<li id="field_16_290" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_290">Estimated Value or Purchase Price $</label>
<div class="ginput_container ginput_container_text"><input name="input_290" id="input_16_290" type="text" value="" class="medium" tabindex="174" aria-invalid="false"></div>
</li>
<li id="field_16_180" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_180">Make / Brand</label>
<div class="ginput_container ginput_container_text"><input name="input_180" id="input_16_180" type="text" value="" class="medium" tabindex="175" aria-invalid="false"></div>
</li>
<li id="field_16_252" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_252">Model Number</label>
<div class="ginput_container ginput_container_text"><input name="input_252" id="input_16_252" type="text" value="" class="medium" tabindex="176" aria-invalid="false"></div>
</li>
<li id="field_16_251" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_251">Year of Manufacture</label>
<div class="ginput_container ginput_container_text"><input name="input_251" id="input_16_251" type="text" value="" class="medium" tabindex="177" aria-invalid="false"></div>
</li>
<li id="field_16_250" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_250">Registration Number</label>
<div class="ginput_container ginput_container_text"><input name="input_250" id="input_16_250" type="text" value="" class="medium" tabindex="178" aria-invalid="false"></div>
</li>
<li id="field_16_249" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_249">Vin Number</label>
<div class="ginput_container ginput_container_text"><input name="input_249" id="input_16_249" type="text" value="" class="medium" tabindex="179" aria-invalid="false"></div>
</li>
<li id="field_16_248" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_248">Kms on the Odometer</label>
<div class="ginput_container ginput_container_text"><input name="input_248" id="input_16_248" type="text" value="" class="medium" tabindex="180" aria-invalid="false"></div>
</li>
<li id="field_16_273" class="gfield hide_on_pdf field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Upload Photo or Documents</label>
<div class="ginput_container ginput_container_fileupload">
<div id="gform_multifile_upload_16_273"
data-settings="{"runtimes":"html5,flash,html4","browse_button":"gform_browse_button_16_273","container":"gform_multifile_upload_16_273","drop_element":"gform_drag_drop_area_16_273","filelist":"gform_preview_16_273","unique_names":true,"file_data_name":"file","url":"https:\/\/secure.capitalempire.com.au\/?gf_page=515745c844a5b20","flash_swf_url":"https:\/\/secure.capitalempire.com.au\/wp-includes\/js\/plupload\/plupload.flash.swf","silverlight_xap_url":"https:\/\/secure.capitalempire.com.au\/wp-includes\/js\/plupload\/plupload.silverlight.xap","filters":{"mime_types":[{"title":"Allowed Files","extensions":"*"}],"max_file_size":"104857600b"},"multipart":true,"urlstream_upload":false,"multipart_params":{"form_id":16,"field_id":273},"gf_vars":{"max_files":"5","message_id":"gform_multifile_messages_16_273","disallowed_extensions":["php","asp","aspx","cmd","csh","bat","html","htm","hta","jar","exe","com","js","lnk","htaccess","phtml","ps1","ps2","php3","php4","php5","php6","py","rb","tmp"]}}"
class="gform_fileupload_multifile" style="position: relative;">
<div id="gform_drag_drop_area_16_273" class="gform_drop_area" style="position: relative;">
<span class="gform_drop_instructions">Drop files here or </span>
<input id="gform_browse_button_16_273" type="button" value="Select files" class="button gform_button_select_files" aria-describedby="extensions_message_16_273" tabindex="181" style="z-index: 1;">
</div>
<div id="html5_1ffjo4glgkchv1l1cmhr9h1d073_container" class="moxie-shim moxie-shim-html5" style="position: absolute; top: 0px; left: 0px; width: 0px; height: 0px; overflow: hidden; z-index: 0;"><input
id="html5_1ffjo4glgkchv1l1cmhr9h1d073" type="file" style="font-size: 999px; opacity: 0; position: absolute; top: 0px; left: 0px; width: 100%; height: 100%;" multiple="" accept=""></div>
</div><span id="extensions_message_16_273" class="screen-reader-text"></span>
<div class="validation_message">
</div>
</div>
<div id="gform_preview_16_273"></div>
</li>
<li id="field_16_184" class="gfield gf_list_inline hide_on_pdf expand_out field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Add Asset / Liability 2?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_184">
<li class="gchoice_16_184_0"><input name="input_184" type="radio" value="No" checked="checked" id="choice_16_184_0" tabindex="182" onclick="gf_apply_rules(16,[192,192,337,258,257,256,255,254,253]);"
onkeypress="gf_apply_rules(16,[192,192,337,258,257,256,255,254,253]);"><label for="choice_16_184_0" id="label_16_184_0">No</label></li>
<li class="gchoice_16_184_1"><input name="input_184" type="radio" value="Yes" id="choice_16_184_1" tabindex="183" onclick="gf_apply_rules(16,[192,192,337,258,257,256,255,254,253]);"
onkeypress="gf_apply_rules(16,[192,192,337,258,257,256,255,254,253]);"><label for="choice_16_184_1" id="label_16_184_1">Yes</label></li>
</ul>
</div>
</li>
<li id="field_16_192" class="gfield gsection main_section_subsection field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h2 class="gsection_title"></h2>
</li>
<li id="field_16_191" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h4>Asset / Liability 2</h4>
</li>
<li id="field_16_336" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Type of Asset 2</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_336">
<li class="gchoice_16_336_0"><input name="input_336" type="radio" value="Property" id="choice_16_336_0" tabindex="184" onclick="gf_apply_rules(16,[337,258,257,256,255,254,253]);"
onkeypress="gf_apply_rules(16,[337,258,257,256,255,254,253]);"><label for="choice_16_336_0" id="label_16_336_0">Property</label></li>
<li class="gchoice_16_336_1"><input name="input_336" type="radio" value="Vehicle or Machinery" id="choice_16_336_1" tabindex="185" onclick="gf_apply_rules(16,[337,258,257,256,255,254,253]);"
onkeypress="gf_apply_rules(16,[337,258,257,256,255,254,253]);"><label for="choice_16_336_1" id="label_16_336_1">Vehicle or Machinery</label></li>
</ul>
</div>
</li>
<li id="field_16_337" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Property Type</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_337">
<li class="gchoice_16_337_0"><input name="input_337" type="radio" value="Residential" id="choice_16_337_0" tabindex="186"><label for="choice_16_337_0" id="label_16_337_0">Residential</label></li>
<li class="gchoice_16_337_1"><input name="input_337" type="radio" value="Commercial" id="choice_16_337_1" tabindex="187"><label for="choice_16_337_1" id="label_16_337_1">Commercial</label></li>
<li class="gchoice_16_337_2"><input name="input_337" type="radio" value="Rural" id="choice_16_337_2" tabindex="188"><label for="choice_16_337_2" id="label_16_337_2">Rural</label></li>
</ul>
</div>
</li>
<li id="field_16_260" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_260">Details</label>
<div class="ginput_container ginput_container_text"><input name="input_260" id="input_16_260" type="text" value="" class="medium" tabindex="189" aria-invalid="false"></div>
</li>
<li id="field_16_188" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_188">Lender</label>
<div class="ginput_container ginput_container_text"><input name="input_188" id="input_16_188" type="text" value="" class="medium" tabindex="190" aria-invalid="false"></div>
</li>
<li id="field_16_187" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_187">Current Debt $</label>
<div class="ginput_container ginput_container_text"><input name="input_187" id="input_16_187" type="text" value="" class="medium" tabindex="191" aria-invalid="false"></div>
</li>
<li id="field_16_189" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_189">Estimated Value or Purchase Price $</label>
<div class="ginput_container ginput_container_text"><input name="input_189" id="input_16_189" type="text" value="" class="medium" tabindex="192" aria-invalid="false"></div>
</li>
<li id="field_16_258" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_258">Make / Brand</label>
<div class="ginput_container ginput_container_text"><input name="input_258" id="input_16_258" type="text" value="" class="medium" tabindex="193" aria-invalid="false"></div>
</li>
<li id="field_16_257" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_257">Model Number</label>
<div class="ginput_container ginput_container_text"><input name="input_257" id="input_16_257" type="text" value="" class="medium" tabindex="194" aria-invalid="false"></div>
</li>
<li id="field_16_256" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_256">Year of Manufacture</label>
<div class="ginput_container ginput_container_text"><input name="input_256" id="input_16_256" type="text" value="" class="medium" tabindex="195" aria-invalid="false"></div>
</li>
<li id="field_16_255" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_255">Registration Number</label>
<div class="ginput_container ginput_container_text"><input name="input_255" id="input_16_255" type="text" value="" class="medium" tabindex="196" aria-invalid="false"></div>
</li>
<li id="field_16_254" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_254">Vin Number</label>
<div class="ginput_container ginput_container_text"><input name="input_254" id="input_16_254" type="text" value="" class="medium" tabindex="197" aria-invalid="false"></div>
</li>
<li id="field_16_253" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_253">Kms on the Odometer</label>
<div class="ginput_container ginput_container_text"><input name="input_253" id="input_16_253" type="text" value="" class="medium" tabindex="198" aria-invalid="false"></div>
</li>
<li id="field_16_274" class="gfield hide_on_pdf field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Upload Photo or Documents</label>
<div class="ginput_container ginput_container_fileupload">
<div id="gform_multifile_upload_16_274"
data-settings="{"runtimes":"html5,flash,html4","browse_button":"gform_browse_button_16_274","container":"gform_multifile_upload_16_274","drop_element":"gform_drag_drop_area_16_274","filelist":"gform_preview_16_274","unique_names":true,"file_data_name":"file","url":"https:\/\/secure.capitalempire.com.au\/?gf_page=515745c844a5b20","flash_swf_url":"https:\/\/secure.capitalempire.com.au\/wp-includes\/js\/plupload\/plupload.flash.swf","silverlight_xap_url":"https:\/\/secure.capitalempire.com.au\/wp-includes\/js\/plupload\/plupload.silverlight.xap","filters":{"mime_types":[{"title":"Allowed Files","extensions":"*"}],"max_file_size":"104857600b"},"multipart":true,"urlstream_upload":false,"multipart_params":{"form_id":16,"field_id":274},"gf_vars":{"max_files":"5","message_id":"gform_multifile_messages_16_274","disallowed_extensions":["php","asp","aspx","cmd","csh","bat","html","htm","hta","jar","exe","com","js","lnk","htaccess","phtml","ps1","ps2","php3","php4","php5","php6","py","rb","tmp"]}}"
class="gform_fileupload_multifile" style="position: relative;">
<div id="gform_drag_drop_area_16_274" class="gform_drop_area" style="position: relative;">
<span class="gform_drop_instructions">Drop files here or </span>
<input id="gform_browse_button_16_274" type="button" value="Select files" class="button gform_button_select_files" aria-describedby="extensions_message_16_274" tabindex="199" style="z-index: 1;">
</div>
<div id="html5_1ffjo4glhkg717571li4inumnm6_container" class="moxie-shim moxie-shim-html5" style="position: absolute; top: 0px; left: 0px; width: 0px; height: 0px; overflow: hidden; z-index: 0;"><input
id="html5_1ffjo4glhkg717571li4inumnm6" type="file" style="font-size: 999px; opacity: 0; position: absolute; top: 0px; left: 0px; width: 100%; height: 100%;" multiple="" accept=""></div>
</div><span id="extensions_message_16_274" class="screen-reader-text"></span>
<div class="validation_message">
</div>
</div>
<div id="gform_preview_16_274"></div>
</li>
<li id="field_16_193" class="gfield gf_list_inline hide_on_pdf expand_out field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Add Asset / Liability 3?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_193">
<li class="gchoice_16_193_0"><input name="input_193" type="radio" value="No" checked="checked" id="choice_16_193_0" tabindex="200" onclick="gf_apply_rules(16,[200,200,338,266,265,264,263,262,261]);"
onkeypress="gf_apply_rules(16,[200,200,338,266,265,264,263,262,261]);"><label for="choice_16_193_0" id="label_16_193_0">No</label></li>
<li class="gchoice_16_193_1"><input name="input_193" type="radio" value="Yes" id="choice_16_193_1" tabindex="201" onclick="gf_apply_rules(16,[200,200,338,266,265,264,263,262,261]);"
onkeypress="gf_apply_rules(16,[200,200,338,266,265,264,263,262,261]);"><label for="choice_16_193_1" id="label_16_193_1">Yes</label></li>
</ul>
</div>
</li>
<li id="field_16_200" class="gfield gsection main_section_subsection field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h2 class="gsection_title"></h2>
</li>
<li id="field_16_199" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h4>Asset / Liability 3</h4>
</li>
<li id="field_16_339" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Type of Asset 3</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_339">
<li class="gchoice_16_339_0"><input name="input_339" type="radio" value="Property" id="choice_16_339_0" tabindex="202" onclick="gf_apply_rules(16,[338,266,265,264,263,262,261]);"
onkeypress="gf_apply_rules(16,[338,266,265,264,263,262,261]);"><label for="choice_16_339_0" id="label_16_339_0">Property</label></li>
<li class="gchoice_16_339_1"><input name="input_339" type="radio" value="Vehicle or Machinery" id="choice_16_339_1" tabindex="203" onclick="gf_apply_rules(16,[338,266,265,264,263,262,261]);"
onkeypress="gf_apply_rules(16,[338,266,265,264,263,262,261]);"><label for="choice_16_339_1" id="label_16_339_1">Vehicle or Machinery</label></li>
</ul>
</div>
</li>
<li id="field_16_338" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Property Type</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_338">
<li class="gchoice_16_338_0"><input name="input_338" type="radio" value="Residential" id="choice_16_338_0" tabindex="204"><label for="choice_16_338_0" id="label_16_338_0">Residential</label></li>
<li class="gchoice_16_338_1"><input name="input_338" type="radio" value="Commercial" id="choice_16_338_1" tabindex="205"><label for="choice_16_338_1" id="label_16_338_1">Commercial</label></li>
<li class="gchoice_16_338_2"><input name="input_338" type="radio" value="Rural" id="choice_16_338_2" tabindex="206"><label for="choice_16_338_2" id="label_16_338_2">Rural</label></li>
</ul>
</div>
</li>
<li id="field_16_198" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_198">Details</label>
<div class="ginput_container ginput_container_text"><input name="input_198" id="input_16_198" type="text" value="" class="medium" tabindex="207" aria-invalid="false"></div>
</li>
<li id="field_16_196" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_196">Lender</label>
<div class="ginput_container ginput_container_text"><input name="input_196" id="input_16_196" type="text" value="" class="medium" tabindex="208" aria-invalid="false"></div>
</li>
<li id="field_16_195" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_195">Current Debt $</label>
<div class="ginput_container ginput_container_text"><input name="input_195" id="input_16_195" type="text" value="" class="medium" tabindex="209" aria-invalid="false"></div>
</li>
<li id="field_16_197" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_197">Estimated Value or Purchase Price $</label>
<div class="ginput_container ginput_container_text"><input name="input_197" id="input_16_197" type="text" value="" class="medium" tabindex="210" aria-invalid="false"></div>
</li>
<li id="field_16_266" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_266">Make / Brand</label>
<div class="ginput_container ginput_container_text"><input name="input_266" id="input_16_266" type="text" value="" class="medium" tabindex="211" aria-invalid="false"></div>
</li>
<li id="field_16_265" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_265">Model Number</label>
<div class="ginput_container ginput_container_text"><input name="input_265" id="input_16_265" type="text" value="" class="medium" tabindex="212" aria-invalid="false"></div>
</li>
<li id="field_16_264" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_264">Year of Manufacture</label>
<div class="ginput_container ginput_container_text"><input name="input_264" id="input_16_264" type="text" value="" class="medium" tabindex="213" aria-invalid="false"></div>
</li>
<li id="field_16_263" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_263">Registration Number</label>
<div class="ginput_container ginput_container_text"><input name="input_263" id="input_16_263" type="text" value="" class="medium" tabindex="214" aria-invalid="false"></div>
</li>
<li id="field_16_262" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_262">Vin Number</label>
<div class="ginput_container ginput_container_text"><input name="input_262" id="input_16_262" type="text" value="" class="medium" tabindex="215" aria-invalid="false"></div>
</li>
<li id="field_16_261" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_261">Kms on the Odometer</label>
<div class="ginput_container ginput_container_text"><input name="input_261" id="input_16_261" type="text" value="" class="medium" tabindex="216" aria-invalid="false"></div>
</li>
<li id="field_16_275" class="gfield hide_on_pdf field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Upload Photo or Documents</label>
<div class="ginput_container ginput_container_fileupload">
<div id="gform_multifile_upload_16_275"
data-settings="{"runtimes":"html5,flash,html4","browse_button":"gform_browse_button_16_275","container":"gform_multifile_upload_16_275","drop_element":"gform_drag_drop_area_16_275","filelist":"gform_preview_16_275","unique_names":true,"file_data_name":"file","url":"https:\/\/secure.capitalempire.com.au\/?gf_page=515745c844a5b20","flash_swf_url":"https:\/\/secure.capitalempire.com.au\/wp-includes\/js\/plupload\/plupload.flash.swf","silverlight_xap_url":"https:\/\/secure.capitalempire.com.au\/wp-includes\/js\/plupload\/plupload.silverlight.xap","filters":{"mime_types":[{"title":"Allowed Files","extensions":"*"}],"max_file_size":"104857600b"},"multipart":true,"urlstream_upload":false,"multipart_params":{"form_id":16,"field_id":275},"gf_vars":{"max_files":"5","message_id":"gform_multifile_messages_16_275","disallowed_extensions":["php","asp","aspx","cmd","csh","bat","html","htm","hta","jar","exe","com","js","lnk","htaccess","phtml","ps1","ps2","php3","php4","php5","php6","py","rb","tmp"]}}"
class="gform_fileupload_multifile" style="position: relative;">
<div id="gform_drag_drop_area_16_275" class="gform_drop_area" style="position: relative;">
<span class="gform_drop_instructions">Drop files here or </span>
<input id="gform_browse_button_16_275" type="button" value="Select files" class="button gform_button_select_files" aria-describedby="extensions_message_16_275" tabindex="217" style="z-index: 1;">
</div>
<div id="html5_1ffjo4glh1ijj9h01gse1nlqc3e9_container" class="moxie-shim moxie-shim-html5" style="position: absolute; top: 0px; left: 0px; width: 0px; height: 0px; overflow: hidden; z-index: 0;"><input
id="html5_1ffjo4glh1ijj9h01gse1nlqc3e9" type="file" style="font-size: 999px; opacity: 0; position: absolute; top: 0px; left: 0px; width: 100%; height: 100%;" multiple="" accept=""></div>
</div><span id="extensions_message_16_275" class="screen-reader-text"></span>
<div class="validation_message">
</div>
</div>
<div id="gform_preview_16_275"></div>
</li>
<li id="field_16_194" class="gfield gf_list_inline hide_on_pdf expand_out field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Add Asset / Liability 4?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_194">
<li class="gchoice_16_194_0"><input name="input_194" type="radio" value="No" checked="checked" id="choice_16_194_0" tabindex="218" onclick="gf_apply_rules(16,[206,206,340,268,269,270,271,272]);"
onkeypress="gf_apply_rules(16,[206,206,340,268,269,270,271,272]);"><label for="choice_16_194_0" id="label_16_194_0">No</label></li>
<li class="gchoice_16_194_1"><input name="input_194" type="radio" value="Yes" id="choice_16_194_1" tabindex="219" onclick="gf_apply_rules(16,[206,206,340,268,269,270,271,272]);"
onkeypress="gf_apply_rules(16,[206,206,340,268,269,270,271,272]);"><label for="choice_16_194_1" id="label_16_194_1">Yes</label></li>
</ul>
</div>
</li>
<li id="field_16_206" class="gfield gsection main_section_subsection field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h2 class="gsection_title"></h2>
</li>
<li id="field_16_205" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h4>Asset / Liability 4</h4>
</li>
<li id="field_16_341" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Type of Asset 4</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_341">
<li class="gchoice_16_341_0"><input name="input_341" type="radio" value="Property" id="choice_16_341_0" tabindex="220" onclick="gf_apply_rules(16,[340,268,269,270,271,272]);"
onkeypress="gf_apply_rules(16,[340,268,269,270,271,272]);"><label for="choice_16_341_0" id="label_16_341_0">Property</label></li>
<li class="gchoice_16_341_1"><input name="input_341" type="radio" value="Vehicle or Machinery" id="choice_16_341_1" tabindex="221" onclick="gf_apply_rules(16,[340,268,269,270,271,272]);"
onkeypress="gf_apply_rules(16,[340,268,269,270,271,272]);"><label for="choice_16_341_1" id="label_16_341_1">Vehicle or Machinery</label></li>
</ul>
</div>
</li>
<li id="field_16_340" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Property Type</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_340">
<li class="gchoice_16_340_0"><input name="input_340" type="radio" value="Residential" id="choice_16_340_0" tabindex="222"><label for="choice_16_340_0" id="label_16_340_0">Residential</label></li>
<li class="gchoice_16_340_1"><input name="input_340" type="radio" value="Commercial" id="choice_16_340_1" tabindex="223"><label for="choice_16_340_1" id="label_16_340_1">Commercial</label></li>
<li class="gchoice_16_340_2"><input name="input_340" type="radio" value="Rural" id="choice_16_340_2" tabindex="224"><label for="choice_16_340_2" id="label_16_340_2">Rural</label></li>
</ul>
</div>
</li>
<li id="field_16_204" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_204">Details</label>
<div class="ginput_container ginput_container_text"><input name="input_204" id="input_16_204" type="text" value="" class="medium" tabindex="225" aria-invalid="false"></div>
</li>
<li id="field_16_202" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_202">Lender</label>
<div class="ginput_container ginput_container_text"><input name="input_202" id="input_16_202" type="text" value="" class="medium" tabindex="226" aria-invalid="false"></div>
</li>
<li id="field_16_201" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_201">Current Debt $</label>
<div class="ginput_container ginput_container_text"><input name="input_201" id="input_16_201" type="text" value="" class="medium" tabindex="227" aria-invalid="false"></div>
</li>
<li id="field_16_203" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_203">Estimated Value or Purchase Price $</label>
<div class="ginput_container ginput_container_text"><input name="input_203" id="input_16_203" type="text" value="" class="medium" tabindex="228" aria-invalid="false"></div>
</li>
<li id="field_16_268" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_268">Model Number</label>
<div class="ginput_container ginput_container_text"><input name="input_268" id="input_16_268" type="text" value="" class="medium" tabindex="229" aria-invalid="false"></div>
</li>
<li id="field_16_269" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_269">Year of Manufacture</label>
<div class="ginput_container ginput_container_text"><input name="input_269" id="input_16_269" type="text" value="" class="medium" tabindex="230" aria-invalid="false"></div>
</li>
<li id="field_16_270" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_270">Registration Number</label>
<div class="ginput_container ginput_container_text"><input name="input_270" id="input_16_270" type="text" value="" class="medium" tabindex="231" aria-invalid="false"></div>
</li>
<li id="field_16_271" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_271">Vin Number</label>
<div class="ginput_container ginput_container_text"><input name="input_271" id="input_16_271" type="text" value="" class="medium" tabindex="232" aria-invalid="false"></div>
</li>
<li id="field_16_272" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_272">Kms on the Odometer</label>
<div class="ginput_container ginput_container_text"><input name="input_272" id="input_16_272" type="text" value="" class="medium" tabindex="233" aria-invalid="false"></div>
</li>
<li id="field_16_276" class="gfield hide_on_pdf field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label">Upload Photo or Documents</label>
<div class="ginput_container ginput_container_fileupload">
<div id="gform_multifile_upload_16_276"
data-settings="{"runtimes":"html5,flash,html4","browse_button":"gform_browse_button_16_276","container":"gform_multifile_upload_16_276","drop_element":"gform_drag_drop_area_16_276","filelist":"gform_preview_16_276","unique_names":true,"file_data_name":"file","url":"https:\/\/secure.capitalempire.com.au\/?gf_page=515745c844a5b20","flash_swf_url":"https:\/\/secure.capitalempire.com.au\/wp-includes\/js\/plupload\/plupload.flash.swf","silverlight_xap_url":"https:\/\/secure.capitalempire.com.au\/wp-includes\/js\/plupload\/plupload.silverlight.xap","filters":{"mime_types":[{"title":"Allowed Files","extensions":"*"}],"max_file_size":"104857600b"},"multipart":true,"urlstream_upload":false,"multipart_params":{"form_id":16,"field_id":276},"gf_vars":{"max_files":"5","message_id":"gform_multifile_messages_16_276","disallowed_extensions":["php","asp","aspx","cmd","csh","bat","html","htm","hta","jar","exe","com","js","lnk","htaccess","phtml","ps1","ps2","php3","php4","php5","php6","py","rb","tmp"]}}"
class="gform_fileupload_multifile" style="position: relative;">
<div id="gform_drag_drop_area_16_276" class="gform_drop_area" style="position: relative;">
<span class="gform_drop_instructions">Drop files here or </span>
<input id="gform_browse_button_16_276" type="button" value="Select files" class="button gform_button_select_files" aria-describedby="extensions_message_16_276" tabindex="234" style="z-index: 1;">
</div>
<div id="html5_1ffjo4glipe1l551q3l1n3n13p0c_container" class="moxie-shim moxie-shim-html5" style="position: absolute; top: 0px; left: 0px; width: 0px; height: 0px; overflow: hidden; z-index: 0;"><input
id="html5_1ffjo4glipe1l551q3l1n3n13p0c" type="file" style="font-size: 999px; opacity: 0; position: absolute; top: 0px; left: 0px; width: 100%; height: 100%;" multiple="" accept=""></div>
</div><span id="extensions_message_16_276" class="screen-reader-text"></span>
<div class="validation_message">
</div>
</div>
<div id="gform_preview_16_276"></div>
</li>
</div>
<li id="field_16_235" class="gfield gsection main_section field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title">Business owner to complete information disclosure statement <span class="m_expand"><span class="m_expand_text">EXPAND <i class="fa fa-chevron-circle-right"></i></span><span class="m_collapse_text"></span></span>
</h2>
</li>
<div class="m_section" style="display: none;">
<li id="field_16_237" class="gfield hide_on_pdf gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_237">Business Owner's Full Name<span
class="gfield_required">*</span></label>
<div class="ginput_container ginput_container_text"><input name="input_237" id="input_16_237" type="text" value="" class="medium" tabindex="235" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_16_238" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible">
<p>I / We, <strong>{{Business Owners Full Name Above}}</strong> grant our irrevocable permission to release our confidential information to EasyBizFinance and/or its affiliated partners. I/We understand this information is being used for
their credit and underwriting purposes only.</p>
</li>
<li id="field_16_327" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_327">Trading Street Address</label>
<div class="ginput_container ginput_container_text"><input name="input_327" id="input_16_327" type="text" value="" class="medium" tabindex="236" aria-invalid="false"></div>
</li>
<li id="field_16_328" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_328">Suburb</label>
<div class="ginput_container ginput_container_text"><input name="input_328" id="input_16_328" type="text" value="" class="medium" tabindex="237" aria-invalid="false"></div>
</li>
<li id="field_16_329" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_329">State</label>
<div class="ginput_container ginput_container_select"><select name="input_329" id="input_16_329" class="medium gfield_select" tabindex="238" aria-invalid="false">
<option value=""></option>
<option value="NSW">NSW</option>
<option value="VIC">VIC</option>
<option value="ACT">ACT</option>
<option value="WA">WA</option>
<option value="TAS">TAS</option>
<option value="NT">NT</option>
</select></div>
</li>
<li id="field_16_330" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_330">Post Code</label>
<div class="ginput_container ginput_container_text"><input name="input_330" id="input_16_330" type="text" value="" class="medium" tabindex="239" aria-invalid="false"></div>
</li>
<li id="field_16_239" class="gfield main_section_subtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible">
<h4>MY LANDLORD INFORMATION</h4>
</li>
<li id="field_16_240" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_240">Landlord / Mortgage company</label>
<div class="ginput_container ginput_container_text"><input name="input_240" id="input_16_240" type="text" value="" class="medium" tabindex="240" aria-invalid="false"></div>
</li>
<li id="field_16_241" class="gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_241">Contact Name</label>
<div class="ginput_container ginput_container_text"><input name="input_241" id="input_16_241" type="text" value="" class="medium" tabindex="241" aria-invalid="false"></div>
</li>
<li id="field_16_242" class="gfield gf_right_half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_242">Phone Number</label>
<div class="ginput_container ginput_container_text"><input name="input_242" id="input_16_242" type="text" value="" class="medium" tabindex="242" aria-invalid="false"></div>
</li>
</div>
<li id="field_16_218" class="gfield gsection main_section field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title">Statement By Borrowers <span class="m_expand"><span class="m_expand_text">EXPAND <i class="fa fa-chevron-circle-right"></i></span><span class="m_collapse_text"></span></span></h2>
</li>
<div class="m_section" style="display: none;">
<li id="field_16_278" class="gfield gf_list_inline gf_yes_no field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Have you or your spouse ever been declared bankrupt or insolvent, or has either
estate been assigned for the benefit of creditors?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_278">
<li class="gchoice_16_278_0"><input name="input_278" type="radio" value="YES" id="choice_16_278_0" tabindex="243"><label for="choice_16_278_0" id="label_16_278_0">YES</label></li>
<li class="gchoice_16_278_1"><input name="input_278" type="radio" value="NO" id="choice_16_278_1" tabindex="244"><label for="choice_16_278_1" id="label_16_278_1">NO</label></li>
</ul>
</div>
</li>
<li id="field_16_280" class="gfield gf_list_inline gf_yes_no field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Have you or your spouse ever been shareholders or officers of any company of
which a manager, receiver or liquidator has been appointed?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_280">
<li class="gchoice_16_280_0"><input name="input_280" type="radio" value="YES" id="choice_16_280_0" tabindex="245"><label for="choice_16_280_0" id="label_16_280_0">YES</label></li>
<li class="gchoice_16_280_1"><input name="input_280" type="radio" value="NO" id="choice_16_280_1" tabindex="246"><label for="choice_16_280_1" id="label_16_280_1">NO</label></li>
</ul>
</div>
</li>
<li id="field_16_281" class="gfield gf_list_inline gf_yes_no field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Is there any unsatisfied judgement entered in any court against you, your spouses
or any company of which either of you or your spouse are or were a shareholder or officer?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_281">
<li class="gchoice_16_281_0"><input name="input_281" type="radio" value="YES" id="choice_16_281_0" tabindex="247"><label for="choice_16_281_0" id="label_16_281_0">YES</label></li>
<li class="gchoice_16_281_1"><input name="input_281" type="radio" value="NO" id="choice_16_281_1" tabindex="248"><label for="choice_16_281_1" id="label_16_281_1">NO</label></li>
</ul>
</div>
</li>
<li id="field_16_282" class="gfield gf_list_inline gf_yes_no field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Have you or your spouse ever been registered with the CRAA as in default?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_282">
<li class="gchoice_16_282_0"><input name="input_282" type="radio" value="YES" id="choice_16_282_0" tabindex="249"><label for="choice_16_282_0" id="label_16_282_0">YES</label></li>
<li class="gchoice_16_282_1"><input name="input_282" type="radio" value="NO" id="choice_16_282_1" tabindex="250"><label for="choice_16_282_1" id="label_16_282_1">NO</label></li>
</ul>
</div>
</li>
<li id="field_16_283" class="gfield gf_list_inline gf_yes_no field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Are you the director or shareholder of any companies?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_16_283">
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</li>
</div>
<li id="field_16_220" class="gfield gsection main_section field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title">I confirm that the above information is complete and correct <span class="m_expand"><span class="m_expand_text">EXPAND <i class="fa fa-chevron-circle-right"></i></span><span class="m_collapse_text"></span></span>
</h2>
</li>
<div class="m_section" style="display: none;">
<li id="field_16_231" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible">
<h4>SIGNATURES </h4>
<h5>(Verification of this authorisation may be obtained by contacting us on the business above)</h5>
<p>By signing this application, I/We certify the above information supplied is true and correct to the best of my/our knowledge and belief. Privacy Act 1988: The Applicant and each Owner named above hereby irrevocably authorises Capital
Empire Pty Ltd, its servants and agents to make such enquiries as they deem necessary to investigate their credit worthiness from time to time, including the making of enquiries with persons nominated as trade references, the bankers of
the Applicant, any credit provider or Credit Reporting Agency and including personal credit and consumer credit information and LandData/property inquiries and name searches (hereinafter called “the sources”). The Applicant and each Owner
hereby authorises the sources to disclose to Capital Empire Pty Ltd such information concerning the Applicant and each Owner which is within their possession. I/we further grant to any source from which Capital Empire Pty Ltd has
requested information about applicant(s), the authorisation to release such information to Capital Empire Pty Ltd. The Applicant and each Owner agrees that the information provided in this application concerning the Applicant and each
Owner and any relevant trading information arising from any dealings between Capital Empire Pty Ltd and the Applicant and each Owner may be disclosed to a Credit Reporting Agency or any other interested person, subject to Capital Empire
Pty Ltd’s Privacy Policy which can be obtained upon request. You authorise Capital Empire Pty Ltd to complete any incomplete sections of this form verbally or via electronic communication with You.</p>
</li>
<li id="field_16_232" class="gfield gsection hide_seperator field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title"></h2>
</li>
<li id="field_16_222" class="gfield gf_left_third field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_222">Signature - Applicant 1</label>
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</li>
<li id="field_16_223" class="gfield gf_middle_third field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_223">Print Name</label>
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<li id="field_16_224" class="gfield gf_right_third field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_224">Date</label>
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</li>
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<h2 class="gsection_title"></h2>
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<li id="field_16_225" class="gfield gf_left_third field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_225">Signature - Applicant 2</label>
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</li>
<li id="field_16_227" class="gfield gf_right_third field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_227">Date</label>
<div class="ginput_container ginput_container_text"><input name="input_227" id="input_16_227" type="text" value="" class="medium" tabindex="258" aria-invalid="false"></div>
</li>
<li id="field_16_234" class="gfield gsection hide_seperator field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h2 class="gsection_title"></h2>
</li>
<li id="field_16_228" class="gfield gf_left_third field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_228">Signature - Applicant 3</label>
<div class="ginput_container ginput_container_text"><input name="input_228" id="input_16_228" type="text" value="" class="medium" tabindex="259" aria-invalid="false"></div>
</li>
<li id="field_16_229" class="gfield gf_middle_third field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_229">Print Name</label>
<div class="ginput_container ginput_container_text"><input name="input_229" id="input_16_229" type="text" value="" class="medium" tabindex="260" aria-invalid="false"></div>
</li>
<li id="field_16_230" class="gfield gf_right_third field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;"><label class="gfield_label" for="input_16_230">Date</label>
<div class="ginput_container ginput_container_text"><input name="input_230" id="input_16_230" type="text" value="" class="medium" tabindex="261" aria-invalid="false"></div>
</li>
</div>
<li id="field_16_285" class="gfield gsection main_section hide_on_pdf field_sublabel_below field_description_below gfield_visibility_visible">
<h2 class="gsection_title">Upload Documents <span class="m_expand"><span class="m_expand_text">EXPAND <i class="fa fa-chevron-circle-right"></i></span><span class="m_collapse_text"></span></span></h2>
</li>
<div class="m_section" style="display: none;">
<li id="field_16_81" class="gfield main_section_subtitle hide_on_pdf gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h4>Please upload relevant documentation including but not limited to:</h4>
<ul>
<li>Transaction overview</li>
<li>Funding table & Feasability</li>
<li>Site Information</li>
<li>Development approval [DA]</li>
<li>CV of builder</li>
<li>Summary of Presales</li>
</ul>
</li>
<li id="field_16_333" class="gfield main_section_subtitle hide_on_pdf gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" style="display: none;">
<h4>Please upload relevant documentation including but not limited to:</h4>
<ul>
<li>Copy of any Recent Valuations</li>
<li>Assets and Liabilities Statement for Borrower (A&L)</li>
<li>A&L for all Guarantors - not included above</li>
</ul>
</li>
<li id="field_16_17" class="gfield hide_on_pdf field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label">Upload Documents</label>
<div class="ginput_container ginput_container_fileupload">
<div id="gform_multifile_upload_16_17"
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<div class="validation_message">
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</li>
<li id="field_16_342" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_16_342">Email</label>
<div class="ginput_container"><input name="input_342" id="input_16_342" type="text" value=""></div>
<div class="gfield_description">This field is for validation purposes and should be left unchanged.</div>
</li>
</div>
</ul>
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</form>Text Content
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
1800 327 924sales@capitalempire.com.auMonday – Friday 9 AM – 6 PM
Online Application
* Return to CapitalEmpire.com.au
1800 327 924
Send us an Email
1800 327 924
Send us an Email
* Return to CapitalEmpire.com.au
1800 327 924sales@capitalempire.com.auMonday – Friday 9 AM – 6 PM
1800 327 924
Send us an Email
APPLICATION & PRIVACY FORM
Please complete the following application form. Once you submit it, you will be
giving the opportunity to print and sign the form.
* Application Reference #
* Type of Finance Required*
* Construction Finance
* Immediate Short Term Finance
* Did somebody refer you to this loan?
* No
* Yes
*
* REFERRER'S DETAILS
* Referrer's Full Name
* Referrer's Email Address
* Referrer's Mobile Number
* APPLICANT DETAILS EXPAND
APPLICANT 1
Capacity of Applicant
* Borrower
* Guarantor
* Joint Applicant
Full Name*
Mobile / Telephone*
Email*
Occupation / Position
Home Street Address
Suburb
State
NSWVICACTWATASNT
Post Code
Driver's Licence No.
Date of Birth
Home Ownership Status
* Own
* Rent
*
Residency Status
* Australian Citizen
* Permanent Resident
*
Years at Home Address
Business Ownership %
Add Applicant 2?
* No
* Yes
APPLICANT 2
Capacity of Applicant
* Borrower
* Guarantor
* Joint Applicant
Full Name
Mobile / Telephone
Occupation / Position
Email
Home Street Address
Suburb
State
NSWVICACTWATASNT
Post Code
Driver's Licence No.
Date of Birth
Home Ownership Status
* Own
* Rent
*
Residency Status
* Australian Citizen
* Permanent Resident
*
Years at Home Address
Business Ownership %
Add Applicant 3?
* No
* Yes
APPLICANT 3
Capacity of Applicant
* Borrower
* Guarantor
* Joint Applicant
Full Name
Mobile / Telephone
Email
Occupation / Position
Home Street Address
Suburb
State
NSWVICACTWATASNT
Post Code
Driver's Licence No.
Date of Birth
Home Ownership Status
* Own
* Rent
*
Residency Status
* Australian Citizen
* Permanent Resident
*
Years at Home Address
Business Ownership %
* BUSINESS DETAILS EXPAND
Type of Entity
* Company
* Partnership
* Sole Trader
*
Company / Trust Name
ABN / ACN
Trading Street Address
Suburb
State
NSWVICACTWATASNT
Post Code
Postal Address different to Trading Address?
* No
* Yes
Postal Street Address
Suburb
State
NSWVICACTWATASNT
Post Code
Principle Business Activity
Business Start Date
Owner's Name
Phone Number
Email
Website
Monthly Rent $
Lease End Date
* DETAILS OF LOAN REQUIRED EXPAND
Loan Amount Required $
Term
(Months)
Settlement Date
If known.
Loan Purpose
Loan Repayment Strategy
(e.g. refinance, sale of property etc)
* SECURITY OFFERED FOR THE LOAN EXPAND
PROPERTY 1
Property Street Address
Suburb
State
NSWVICACTWATASNT
Post Code
Ownership of Property
* Being Purchased
* Already Owned
Type of Property
* Residential
* Commercial
* Vacant Land
Estimated Value or Purchase Price $
Rental Value Per Week $
(if applicable)
Lender
Current Debt $
Notes or Comments?
Add Security Property 2?
* No
* Yes
PROPERTY 2
Property Street Address
Suburb
State
NSWVICACTWATASNT
Post Code
Ownership of Property
* Being Purchased
* Already Owned
Type of Property
* Residential
* Commercial
* Vacant Land
Estimated Value or Purchase Price $
Rental Value Per Week $
(if applicable)
Lender
Current Debt $
Notes or Comments?
Add Security Property 3?
* No
* Yes
PROPERTY 3
Property Street Address
Suburb
State
NSWVICACTWATASNT
Post Code
Ownership of Property
* Being Purchased
* Already Owned
Type of Property
* Residential
* Commercial
* Vacant Land
Estimated Value or Purchase Price $
Rental Value Per Week $
(if applicable)
Lender
Current Debt $
Notes or Comments?
Add Security Property 4?
* No
* Yes
PROPERTY 4
Property Street Address
Suburb
State
NSWVICACTWATASNT
Post Code
Ownership of Property
* Being Purchased
* Already Owned
Type of Property
* Residential
* Commercial
* Vacant Land
Estimated Value or Purchase Price $
Rental Value Per Week $
(if applicable)
Lender
Current Debt $
Notes or Comments?
* ADDITIONAL ASSETS AND LIABILITIES EXPAND
ASSET / LIABILITY 1
Type of Asset 1
* Property
* Vehicle or Machinery
Property Type
* Residential
* Commercial
* Rural
Details
Lender
Current Debt $
Estimated Value or Purchase Price $
Make / Brand
Model Number
Year of Manufacture
Registration Number
Vin Number
Kms on the Odometer
Upload Photo or Documents
Drop files here or
Add Asset / Liability 2?
* No
* Yes
ASSET / LIABILITY 2
Type of Asset 2
* Property
* Vehicle or Machinery
Property Type
* Residential
* Commercial
* Rural
Details
Lender
Current Debt $
Estimated Value or Purchase Price $
Make / Brand
Model Number
Year of Manufacture
Registration Number
Vin Number
Kms on the Odometer
Upload Photo or Documents
Drop files here or
Add Asset / Liability 3?
* No
* Yes
ASSET / LIABILITY 3
Type of Asset 3
* Property
* Vehicle or Machinery
Property Type
* Residential
* Commercial
* Rural
Details
Lender
Current Debt $
Estimated Value or Purchase Price $
Make / Brand
Model Number
Year of Manufacture
Registration Number
Vin Number
Kms on the Odometer
Upload Photo or Documents
Drop files here or
Add Asset / Liability 4?
* No
* Yes
ASSET / LIABILITY 4
Type of Asset 4
* Property
* Vehicle or Machinery
Property Type
* Residential
* Commercial
* Rural
Details
Lender
Current Debt $
Estimated Value or Purchase Price $
Model Number
Year of Manufacture
Registration Number
Vin Number
Kms on the Odometer
Upload Photo or Documents
Drop files here or
* BUSINESS OWNER TO COMPLETE INFORMATION DISCLOSURE STATEMENT EXPAND
Business Owner's Full Name*
I / We, {{Business Owners Full Name Above}} grant our irrevocable permission
to release our confidential information to EasyBizFinance and/or its
affiliated partners. I/We understand this information is being used for their
credit and underwriting purposes only.
Trading Street Address
Suburb
State
NSWVICACTWATASNT
Post Code
MY LANDLORD INFORMATION
Landlord / Mortgage company
Contact Name
Phone Number
* STATEMENT BY BORROWERS EXPAND
Have you or your spouse ever been declared bankrupt or insolvent, or has
either estate been assigned for the benefit of creditors?
* YES
* NO
Have you or your spouse ever been shareholders or officers of any company of
which a manager, receiver or liquidator has been appointed?
* YES
* NO
Is there any unsatisfied judgement entered in any court against you, your
spouses or any company of which either of you or your spouse are or were a
shareholder or officer?
* YES
* NO
Have you or your spouse ever been registered with the CRAA as in default?
* YES
* NO
Are you the director or shareholder of any companies?
* YES
* NO
* I CONFIRM THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT EXPAND
SIGNATURES
(VERIFICATION OF THIS AUTHORISATION MAY BE OBTAINED BY CONTACTING US ON THE
BUSINESS ABOVE)
By signing this application, I/We certify the above information supplied is
true and correct to the best of my/our knowledge and belief. Privacy Act
1988: The Applicant and each Owner named above hereby irrevocably authorises
Capital Empire Pty Ltd, its servants and agents to make such enquiries as
they deem necessary to investigate their credit worthiness from time to time,
including the making of enquiries with persons nominated as trade references,
the bankers of the Applicant, any credit provider or Credit Reporting Agency
and including personal credit and consumer credit information and
LandData/property inquiries and name searches (hereinafter called “the
sources”). The Applicant and each Owner hereby authorises the sources to
disclose to Capital Empire Pty Ltd such information concerning the Applicant
and each Owner which is within their possession. I/we further grant to any
source from which Capital Empire Pty Ltd has requested information about
applicant(s), the authorisation to release such information to Capital Empire
Pty Ltd. The Applicant and each Owner agrees that the information provided in
this application concerning the Applicant and each Owner and any relevant
trading information arising from any dealings between Capital Empire Pty Ltd
and the Applicant and each Owner may be disclosed to a Credit Reporting
Agency or any other interested person, subject to Capital Empire Pty Ltd’s
Privacy Policy which can be obtained upon request. You authorise Capital
Empire Pty Ltd to complete any incomplete sections of this form verbally or
via electronic communication with You.
Signature - Applicant 1
Print Name
Date
Signature - Applicant 2
Print Name
Date
Signature - Applicant 3
Print Name
Date
* UPLOAD DOCUMENTS EXPAND
PLEASE UPLOAD RELEVANT DOCUMENTATION INCLUDING BUT NOT LIMITED TO:
* Transaction overview
* Funding table & Feasability
* Site Information
* Development approval [DA]
* CV of builder
* Summary of Presales
PLEASE UPLOAD RELEVANT DOCUMENTATION INCLUDING BUT NOT LIMITED TO:
* Copy of any Recent Valuations
* Assets and Liabilities Statement for Borrower (A&L)
* A&L for all Guarantors - not included above
Upload Documents
Drop files here or
Email
This field is for validation purposes and should be left unchanged.
Save and Continue Later
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