Personal details
First Name
*
Middle Name
Surname
*
Email Address
*
Marital Status
*
Married
Defacto
Single
Divorced
Seperated
Mother's maiden name
*
Mobile phone number
*
Date of birth
*
Do you have children?
*
Yes
No
How old are your children?
Are you an Australian Citizen?
*
Yes
No
Are you a permanent resident of Australia?
*
Yes
No
Which country were you born in?
*
Are you a tax resident of a country other than Australia?
*
Yes
No
Not sure
Do you have a student HELP debt?
*
Yes
No
What is your student HELP balance (approx.)?
Residential address history
Please provide 3 years of residential history
Current residential address
*
Start date current address
*
Residential status
*
Renting
With parents
Own home
Boarding
Rent paid per week
Previous residential address
*
Start date previous address
*
Previous residential status
*
Renting
With parents
Boarding
Own home
Prior residential address
*
Start date prior address
*
Prior residential status
*
Renting
With parents
Own home
Boarding
Further prior residential address
*
Start date this address
*
Further prior residential status
*
Renting
Own home
With parents
Boarding
Employment history
Please provide 3 years of employment history
Are you currently employed?
*
Yes
No
Are you a contractor?
Yes
No
Employment Type
*
PAYG employee
Self employed
Employment status
*
Student
Domestic duties
On maternity leave
Retired
Start date domestic duties
Start date retirement
Start date student
Start date on benefits
Start date maternity leave
Current employment basis
*
Full time
Part time
Casual
Do you have a 2nd job?
Yes
No
Employer name
*
Start date current employment
*
Job title
*
Employer phone number
*
Employer address
*
Are you employed on a fixed term contract?
Yes
No
Do you have a salary sacrifice arrangement in place?
*
Yes
No
Please describe the salary sacrifice arrangement
*
Self employed status
Sole Trader
Company
Company Name
Trading Name
Trading phone no.
Trading address
ABN
ACN
Employer name 2nd job
Start Date 2nd job
Job Title 2nd job
Employer phone no. 2nd job
Employer address 2nd job
Employment basis 2nd job
Full time
Part time
Casual
Previous employer name
*
Start date with previous employer
*
Previous Job Title
*
Previous employer phone no.
*
Previous employer address
*
Previous employment basis
*
Full Time
Casual
Part time
Prior employer name
*
Start date prior employment
*
Prior job title
*
Prior employer phone no.
*
Prior employer address
*
Prior employment basis
*
Full time
Part time
Casual
Further prior employer name
*
Start date with this employer
*
Further prior job title
*
Further prior employer phone no.
*
This employer address
*
This employment basis
*
Full time
Part time
Casual
Any other information to help us understand your last 3 years of employment:
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