Remedy Finance Caveat Loan Application Form

Company / Trust Name

Registered Address

Company ABN

Company Phone - Fax

-

Company Director One

Company Director Two

Company Director Three

Loan Term (specify if Other)

Loan Amount

Date Required

Exit Strategy (Loan Repayment)

Declaration of Loan Purpose

Personal Details:

Applicant 1

Applicant 2

Name

DOB

Marital Status

Photo ID

ID# Exp

Home Phone #

Mobile Phone #

Fax #

email address

Residential Details:

Home Address

Status:

Length of time at this address

Name of owner/ agent

Previous address

Status:

Length of time at that address

Dependants Details:

Dependant Children?

Yes No

Ages of Children

Employment Details:

Employers Name

Employers Address

Telephone #

Occupation

Employment Status

Gross Income

/

Time in Job

Previous Employer

Previous Occupation

Other Income

If Self Employed:

ABN:

Accountant:

Deposit

$

First Home Buyer?

Yes No

Assets Details:

ASSETS

VALUE

Property 1

Property 2

Vehicles

Contents

Other

Savings 1 BSB ACC

Savings 2 BSB ACC

Total:

Liabilities Details:

	LIABILITIES	PAYMENTS	BALANCE / LIMIT
Mortgage 1
Mortgage 2
Overdraft
Car Loans
Personal
Credit Cards
Other
	Totals:

Credit History Details:

Credit History

Please advise if you have any defaults or judgements, how much they are, and whether they are paid or unpaid.

Additional Comments

Explanation of defaults, etc.

Security 1 Address

P/C:

Security 2 Address

P/C:

References:

Reference 1

Reference 2

Name

Address

Phone

How did you find us?

TERMS AND CONDITIONS - Please Read Carefully

PRIVACY PROTECTION OF INFORMATION:

IMPORTANT NOTICE TO APPLICANT(S) FOR CREDIT (Section 18 (8)(c) Privacy Act 1988)

Please read carefully.

remedyfinance.com.au may give information about you to a credit reporting agency but only limited kinds of information allowed by the Privacy Act 1988 (Commonwealth) This includes:

* Identity particulars - this only includes your name, sex, date of birth, current known address, two immediate previous addresses, your current or last known employer, and your drivers licence number.
* The fact that you have applied for credit and the amount.
* The fact that remedyfinance.com.au is a credit provider to you.
* Payments overdue for at lease 60 days, which remedyfinance.com.au has taken steps to recover.
* Advice that payments are no longer due.
* Cheques for an amount over $100, drawn by you which have been dishonoured more than once.
* The opinion of remedyfinance.com.au that you have committed a serious credit infringement
* When the credit to you has been discharged.

STATEMENT BY APPLICANT(S) FOR CREDIT.

Please read carefully before signing. When more than 1 applicant , each applicant to sign.

1. TYPE OF CREDIT

The credit I am applying for is wholly or primarily for a domestic, family or household purpose (consumer credit)

2. GIVING INFORMATION TO A CREDIT REPORTING AGENCY (SECTION 18E(8) (C) PRIVACY ACT 1988)

remedyfinance.com.au has informed me that it may give my personal information to a credit reporting agency.  I understand that remedyfinance.com.au can only give limited kinds of information which are set out in the Privacy Act 1988 and examples of which are listed previously.

	3.	EXCHANGING INFORMATION WITH OTHER CREDIT PROVIDERS (SECTION 18N(1) (B) PRIVACY ACT 1988)

I agree to remedyfinance.com.au checking personal information about me with any credit provider named in my application, and with other credit providers that may be named in a credit report issued by a credit reporting agency, for the following purposes.
* To assess my creditworthiness
* To assess an application by me for credit 
* To help me avoid defaulting on my credit obligations
* To notify a default by me
* The collection of overdue amounts

I understand that this information can include any information about my credit worthiness, credit standing, credit history or credit capacity that credit providers are allowed to give or receive from each other under the Privacy Act 1988.

4. CONSENT TO USE INFORMATION

I/We hereby authorise remedyfinance.com.au to use the personal information contained in this application, and if approved, supplying and administering the products and services to me for which I have applied.  I understand that in order to consider this application and if approved, in order for remedyfinance.com.au to supply the products and services to me for which I have applied, it may be necessary for remedyfinance.com.au to provide information contained in this application form to its related entities and other service providers, our agents as well as your agents and contractors, including your finance broker, accountant, legal adviser builder and settlement agent.  I / We represent that, if at any time we supply you with personal information about another person (for example a referee), we are authorised to do so and we agree to inform that person who you are and that you will use and disclose their personal information for the purpose set out above, and that they can gain access to that information.

5. DECLARATIONS

I declare that I am the owner of the assets listed in this application.

I declare that the information in this application is true and correct.

I declare that I am not an un-discharged Bankrupt, and there are no outstanding claims or judgements against me.

I understand that I am liable to pay remedyfinance.com.au reasonable costs and expenses in regards to processing this application and the preparation and stamping of any documents.

I understand that any false declaration will render any loan document null and void, and I will be liable to make full payment of any outstanding amounts plus interest owed to remedyfinance.com.au

By clicking the Submit Application button you confirm you have read and understand the terms and conditions above.