A customer finance questionnaire is answered by a customer who is looking for capital for a specific reason. Financial institutions like banks ask the customer to fill up this form so that they get an idea of the customer’s financial situation and based on it decide what amount of finance can be allotted to the customer.

Sample Customer Finance Questionnaire:

Name: _______________________

Gender: ______________

Date of Birth: ________________

Phone Number: ________________

Address: ____________

Email id: _____________________________

Marital Status: ____________

1) What is your employment type?

a) Salaried

b) Self-employed

2) What is your occupation? __________

3) Describe your basic job responsibilities. _________

4) What is the name of your employer? ____________

5) What is the address of your workplace? _______________

6) How many years have you worked at your current post? __________

7) What is your gross annual income?

a) Less than $100,000

b) $100,000 to 200,000

c) More than $200,000

8) Please give a list of your assets

a) Land

b) House

c) Vehicle

d) Others

9) Please mention the value of each of the assets owned by you. _________

10) Please give a list of your liabilities if any.

a) Rent              Amount per month_______

b) Car Loan        Amount per month_______

c) Home loan              Amount per month_______

d) Personal loans Amount per month_______

e) Credit card bills ___________

f) Others _____________

11) What are your personal monthly expenses? __________

12) Why are you looking for finance with our firm?

a) Looking for property

b) Found property to buy

c) To release equity

d) To refinance property

e) Others