Asset and Liability Statement

Please complete all sections below. Your information will be used to generate a completed document and submitted securely to our team.

Guarantor Details

Guarantor 1

Guarantor Full Name *

Date of Birth *

Occupation

Guarantor 2 (if applicable)

Guarantor Full Name

Date of Birth

Address & Entity

Guarantor Address *

Suburb / Town *

State

Postcode

Related Borrowing Entity

Liabilities

Loans

Name of Lender	Monthly Repayments ($)	Amount Owing ($,000)

Other Loans

Name of Lender	Monthly Repayments ($)	Amount Owing ($,000)

Leases

Name of Lender	Monthly Repayments ($)	Amount Owing ($,000)

Tax Due — Monthly Repayments ($)

Tax Due — Amount Owing ($,000)

Other Creditors — Monthly Repayments ($)

Other Creditors — Amount Owing ($,000)

Assets

Land and Buildings — Property

Property Description / Address	Value ($,000)

Livestock — Type

Livestock — Value ($,000)

Plant / Vehicles

Description	Value ($,000)

Investments

Description	Value ($,000)

Bank Accounts

Bank / Account Description	Value ($,000)

Other Assets — Description

Other Assets — Value ($,000)

Calculated Summary

Total Assets

Total Liabilities

Net Worth

Security Schedule

Financial Institution	Amount Owing ($)	Asset Secured	Market Value ($)	Owner

Contingent Liabilities

Name	Amount Owing ($)	Financial Institution	Market Value ($)	Owner

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Asset and Liability Statement

Guarantor Details

GUARANTOR NAME

DATE OF BIRTH

GUARANTOR NAME 2

DATE OF BIRTH 2

GUARANTOR ADDRESS

SUBURB / TOWN

STATE

POSTCODE

OCCUPATION

RELATED BORROWING ENTITY

Liabilities

Category	Mthly Repay	Amt Owing
Total Liabilities

Assets

Category	Value ($,000)
Total Assets
Less total liabilities
Net Worth

Security Schedule

Financial Institution	Amount Owing	Asset Secured	Market Value	Owner

Contingent Liabilities

Name	Amount Owing	Financial Institution	Market Value	Owner

Authorisation

I / We certify that the above information is complete and correct and that the assets referred to are not subject to any encumbrances, trusts or other interests except as disclosed and that there are no material omissions.

Signature

Date

Name

Signature

Date

Name

Thank You,

Asset and Liability Statement

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