Personal Details
First name
Last name
Date of birth
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Month
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Mobile phone
Email
What is your citizenship status?
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Australian Citizen
New Zealand Citizen
Permanent Resident
Address Details
Address Line 1
Address Line 2
(optional)
Suburb
State
State
WA
NSW
QLD
ACT
VIC
TAS
NT
SA
Postal Code
Current Employer Details
Employment type
select
Full-time
Part-time
Casual
Self-Employed/Contract
Gig Work such as Uber, Airtasker, etc.
Occupation
Employer name
Job Start date
Day
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Month
January
February
March
April
May
June
July
August
September
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December
Loan Details
Loan Amount
Loan Reason
Loan Reason
Bills/Debt - Medical/dental bill
Bills/Debt - Utilities bill
Bills/Debt - veterinary bil
Bills/Debt - Fine
Bills/Debt - Debt consolidation
Bills/Debt - Outstanding debt
Bills/Debt - Tax debt
Bills/Debt - Legal fees
Bills/Debt - Emergency
Bills/Debt - School / Education
Bills / Debt - Other
Home - Home improvements/repair
Home - Appliance purchase
Home - Household furnishings
Home - Technology purchase
Home - Rental bond/cleaning
Home - Home refinance/purchase
Home - Utilities bill
Home - Other
Vehicle - Car purchase
Vehicle - Motorbike purchase
Vehicle - Marine craft purchase
Vehicle - Other vehicle purchase
Vehicle - Vehicle accessories/modifications
Vehicle - Vehicle repairs
Vehicle - Vehicle expenses
Event/Special Occasion - Wedding
Event/Special occasion - Funeral
Event/Special occasion - Birthday
Event/Special occasion - Seasonal / Religious Holiday
Event/Special occasion - Other special event
Lifestyle - Holiday/travel
Lifestyle - Education
Lifestyle - Recreational activity
Lifestyle - Technology purchase
Lifestyle - Luxury purchase
Lifestyle - Other
Business - Hire or purchase equipment
Business - Pay suppliers
Business - Grow or expand business
Business - Purchasing inventory
Business - Renovationbusiness_working_capital
Business - Working capital
Business - Pay off non-tax debt
Business - Pay off taxt-debt
Business - Other
What is most important to you ?
Please choose an option
Getting funds quickly
Finding someone who will approve me
Getting the best value
Getting help finding the right product (e.g. broker)
How is your current credit score ?
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Excellent
Very good
Good
Fair
Low
Providing security may increase your chances of funding and improve offers from lenders. Are you willing and able to provide some form of security as part of your application?
Please choose an option
Yes, a vehicle
Yes, another asset
No, but can provide a guarantor
No
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and
Target Market Determination
of Breezy Loans and Installment Loans and acknowledge that by clicking submit my personal information will be provided to third partiesfor the loan assessment purpose.
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