Home Ownership Expression of Interest

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.)
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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
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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.
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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.
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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
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