Home Ownership Expression Of Interest - Indigenous Business Australia (Iba)

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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.
A. PERSONAL DETAILS
Applicant 1
Applicant 2
Title
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
Yes – list name/s below
No
No
Date of birth
/
/
/
/
Current address
State
Postcode
State
Postcode
Phone
(H)
(W)
(H)
(W)
(M)
(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
Neither
Torres Strait Islander descent?
Driver’s licence number
Marital status
Married
De facto*
Married
De facto*
Single / Separated / Widowed/er
Single / Separated / Widowed/er
Have you previously owned a
Yes / No
Yes / No
home or had a home loan?
Have you ever been declared bankrupt or
Yes / No
Yes / No
entered into a Part IX debt agreement?
If yes, provide details in section
‘M. FURTHER INFORMATION’.
* 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.

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