OFFICE USE ONLY Lead no: Home Ownership Expression of Interest Complete this form if you wish to register your interest in an Indigenous Business Australia (IBA) housing loan. Once completed, submit the form together with supporting documents to IBA for assessment. If you are assessed as eligible for an IBA housing loan, your name will be placed on IBA’s Expression of Interest Register. If you are married or in a de facto* relationship, you and your partner must both complete this form. If you have difficulty with any of the questions, please Freecall™ 1800 107 107** (select option 1) to speak with your local IBA Lending Officer. IBA respects the privacy of all customers and is committed to maintaining your privacy. More information on how IBA handles your personal information can be found in our Privacy Policy, available at www.iba.gov.au. For information about how IBA handles your credit information, please see our Credit Information Policy, available at www.iba.gov.au. A. PERSONAL DETAILS Applicant 1 Title Applicant 2 Mr / Mrs / Miss / Ms / Other _______ (please specify) Mr / Mrs / Miss / Ms / Other _______ (please specify) First name Middle name/s Family name Have you ever used any name other than the name declared above? (For example, a maiden name or traditional name.) Yes – list name/s below Date of birth / / Yes – list name/s below No / No / Current address State Phone (H) (M) Postcode (W) State (H) Postcode (W) (M) Best daytime phone number Home Work Mobile Home Work Mobile Email Are you of Aboriginal or Aboriginal Torres Strait Islander Neither Aboriginal Torres Strait Islander descent? Torres Strait Islander Neither Driver’s licence number Marital status Married Single / Separated / Widowed/er Have you previously owned a home or had a home loan? 013-03-2014 Have you ever been declared bankrupt or entered into a Part IX debt agreement? If yes, provide details in section ‘L. FURTHER INFORMATION’. De facto* Married De facto* Single / Separated / Widowed/er Yes / No Yes / No Yes / No Yes / No * A de facto relationship is where two adult people, who are not married to each other (including opposite sex and same sex relationships), are partnered and living together (or usually living together) as a couple. ** Calls to 1800 numbers are free from your home phone. Calls from mobile or public phones may be timed and charged at a higher rate. B. NAMES AND DETAILS OF THE PEOPLE WHO WILL LIVE WITH YOU Please list the names and details of the people who will live with you in the home you wish to buy, refinance or build. Name Age Relationship to you Aboriginal Torres Strait Financially Islander Neither independent Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No C. EMPLOYMENT DETAILS Applicant 1 Applicant 2 Employer’s name Employer’s address State Postcode State Postcode Occupation Job type Full time Self employed/contractor Part time Casual Full time Part time Casual Self employed/contractor Work phone number Work email Length of time with this employer Years You are paid Weekly Fortnightly Your income before tax is $ Months Years Monthly Weekly Months Fortnightly Monthly $ If you have been with this employer for less than 12 months, please provide details of your previous employment. Previous employer’s name Occupation Job type Full time Self employed/contractor Length of time with this employer Part time Casual Years Do you receive other income not mentioned above? Full time Self employed/contractor Months Yes / No Part time Years Months Yes / No Description (For example, second job, Centrelink, child maintenance, Family Tax Benefit A or B, pension.) If yes, please specify the fortnightly amount $ 2 $ Casual D. CURRENT RENTAL OR LIVING SITUATION Applicant 2 only needs to complete this section if they currently live at a separate address to Applicant 1. Name of real estate agent, organisation or person from whom the house is rented Applicant 1 Applicant 2 Do you rent from an Indigenous organisation? Yes / No Yes / No Do you live with parents, relatives or friends? Yes / No Yes / No You pay rent Weekly The amount of rent is Fortnightly Monthly $ Weekly Fortnightly Monthly $ How long have you been at this address? E. HOME OWNERSHIP (HOUSE AND / OR LAND) a) If either applicant has previously owned a home or land, please specify the following: Address of property Year of purchase Purchase price $ Year of sale Sale price $ Please state your reason/s for selling the home or land. (If insufficient space, please use section L. FURTHER INFORMATION.) b) If either applicant currently has a mortgage or owns a home and / or land, please specify the following: Address of property Purchase price $ Year of purchase Original loan amount $ Original interest rate Name of lender % Original monthly repayments $ Loan term years Estimated current value $ Current interest rate % Current monthly repayments $ Less loan balance $ = Equity Why do you want to change your home loan to IBA? Show relevant dates and attach copies of supporting documents. That is, current loan contract, loan statements, and/or council rates notice. (If insufficient space, please use section L. FURTHER INFORMATION.) 3 F. FINANCIAL DETAILS Please give details of your combined savings (that is Applicant 1 and Applicant 2). Name of financial institution Branch Current balance $ $ $ Total savings $ Please give details of your other commitments (for example, car loans, personal loans, credit cards, store accounts, or debtor arrangements). Lender Commitment type (eg: car loan) Monthly payment Balance of loan $ $ $ $ $ $ $ $ $ $ $ $ Card limit Payments are Up to date In arrears Please give details of other commitments you have paid off in the past two years (for example, car loans, personal loans, credit cards, store accounts, or debtor arrangements). Lender Commitment type (eg: car loan) Loan amount $ $ $ $ Have you ever received a loan from IBA, ATSIC, ADC or ALC? If yes, please specify the borrower’s name/s Property (address) or business (business name) that loan is / was for Loan number if known 4 Yes / No Repaid in (year) Length of loan (no. of years) G. PURPOSE FOR IBA HOUSING LOAN If eligible to apply for an IBA housing loan, I / we wish to: Buy an established home Build a home on land I own or am paying off Buy a house and land package Do home improvements, repairs or maintenance Buy a flat, townhouse or unit Refinance an existing housing loan Buy land and build a home Buy out my partner’s share of property (property settlement) Not sure yet H. DOCUMENTS YOU NEED TO PROVIDE When you submit this form, you need to provide certain documents (all information supplied to IBA will become the property of IBA). Tick the boxes to indicate what you have included. 1. Confirmation of Aboriginal or Torres Strait Islander Descent form (original document). 2. P roof of your income (for example, two recent consecutive payslips, a letter from your employer or, if self-employed, a copy of your income tax returns for the last two years and income and expenditure statements of the business for the last two years). Please remove or delete your tax file number before submitting to IBA. 3. E vidence of your ability to pay legal and stamp duty costs (for example, a copy of recent bank, building society, credit union statements).* 4. Evidence of your ability to provide the deposit or equity. 5. D etails of current land or home ownership not financed through IBA (that is, a copy of your most recent council rates notice, current loan agreement and your past six months of home loan statements). 6. C ompleted Consent to use your personal information form (original document). * Not required for applicants interested in purchasing or constructing a house in a discrete Indigenous community where land title is held communally. 5 I. DECLARATION I / we acknowledge that: 1. There is no commitment on the part of Indigenous Business Australia to provide me / us with a loan. 2. This is not a formal application for a loan and my / our final eligibility cannot be determined until the formal housing loan application is received. 3. I / we will be invited to submit a formal loan application at a time determined by Indigenous Business Australia in accordance with its policies. I / we declare that the information set out above is true and complete and hereby apply for placement on the Expression of Interest Register. Applicant 1 Applicant 2 Print name Print name Signature Signature Date Date J. CHECKLIST Please tick the boxes to indicate you have checked that your form is complete. Have you answered all the questions in full? Have you provided all relevant documents listed in section H? Have all applicants signed and dated the form in section I? If you are unsure, please call your local IBA Lending Officer on Freecall™ 1800 107 107* (select option 1) for assistance before submitting your Expression of Interest. * Calls to 1800 numbers are free from your home phone. Calls from mobile or public phones may be timed and charged at a higher rate. 6 K. CUSTOMER CONSENT FOR CENTRELINK CONFIRMATION SERVICES Only fill in this section if you receive Centrelink benefits. If you do not wish other joint applicants to see your consent for Centrelink Confirmation Services, please contact IBA to request a separate Centrelink consent form. Applicant 1 Centrelink reference number/s Applicant 2 This consent will be used for the sole purpose of authorising the Department of Human Services (the department) to provide information to Indigenous Business Australia to assess your eligibility in relation to housing finance being sought from Indigenous Business Australia. I / we Applicant 1 Applicant 2 authorise the department to electronically provide a statement of information to Indigenous Business Australia to assist in the assessment of my entitlement to services from Indigenous Business Australia. I / we acknowledge that: 1. The information provided by the department may include, where relevant, current or historical details of payments received, dependants, Centrelink deductions, income, assets and confirmation of my current address. 2. Once signed, this authority is effective only for the period I am a customer of Indigenous Business Australia. 3. This authority, which is ongoing, can be revoked by me / us at any time by giving notice to Indigenous Business Australia. 4. I / we can obtain a written copy of the statements at any time from either Indigenous Business Australia or the department. More information about Centrelink’s Confirmation Services is available from the department shopfronts and the department website at www.humanservices.gov.au Applicant 1 Applicant 2 Print name Print name Signature Signature Date 7 Date L. FURTHER INFORMATION 8