Apply For Finance

This application is for*

Referred by*

Individuals

Individual Applicant 1

Individual Applicant 2

Title eg Mr/Mrs/Ms/Miss/Dr*

Title eg Mr/Mrs/Ms/Miss/Dr

Family Name*

Family Name

Given Name*

Given Name

Capacity of Applicant*

Capacity of Applicant

Present Home Address*

Street Address Suburb State Postal Code

Present Home Address

Street Address Suburb State Postal Code

Phone Work

Phone Home*

Phone Home

Email Address*

Email Address

Company / Trust

Name*

ACN*

Type of business*

Address*

Street Address Address Line 2 Suburb State Postal Code

Trading Address

Street Address Address Line 2 Suburb State Postal Code

Phone*

Fax

Incorporation Date*

Principle Activity*

Advisor Details

Solicitor

Accountant

Name of firm

Address

Street Address Address Line 2 Suburb State Postal Code

Address

Street Address Address Line 2 Suburb State Postal Code

Phone

Fax

Contact Name

First Last

Contact Name

First Last

DX No

Location

Details of loan required

Loan amount required*

Term (Months)*

Expected settlement date*

LOAN PURPOSE:*

LOAN REPAYMENT STRATEGY (eg refinance, sale of property etc):*

Security offered for the loan

Property 1

Property 2

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Zoning

Folio Identifier

Use of Property

Ownership of Property

Estimated Valueor Purchase Price $

Rental Value per week (if app.) $

Quick Valuation* (refer below to costs)

Yes

Quick Valuation* (refer below to costs)

Yes

Contact Name for our Valuer to gain access to property*

Phone (Business Hours)*

Phone (After Hours)*

Phone (Mobile)*

Personal Financial Statements

Applicant name*

Applicant name

Liabilities

Assets

Mortgage with

Property 1

Street Address City State / Province / Region ZIP / Postal Code

Total amount $

Cost Per Month $

Mortgage with

Property 2

Street Address City State / Province / Region ZIP / Postal Code

Total amount $

Cost Per Month $

Mortgage with

Property 3

Street Address City State / Province / Region ZIP / Postal Code

Total amount $

Cost Per Month $

Car leasing with

Cash at bank $

Total amount $

Deposit Paid on Property $

Cost Per Month $

Motor vehicles $

Overdraft amount $

Personal Effects $

Other Loans $

Superannuation $

Cost Per Month $

Business Value $

Credit Card Limit $

Shares and Investments $

Cost Per Month $

Credit Card Limit $

Cost Per Month $

Total Liabilities $

Total Assets $

Surplus Assets $

Statement by borrower/s

Have you or your spouse ever been declared bankrupt or insolvent, or has either estate been assigned for the benefit of creditors?*

Yes
No

Have you or your spouse ever been shareholders or officers of any company of which a manager, receiver or liquidator has been appointed?*

Yes
No

Is there any unsatisfied judgement entered in any court against you, your spouses or any company of which either of you or your spouse are or were a shareholder or officer?*

Yes
No

Have you or your spouse ever been registered with the CRAA as in default?*

Yes
No

Are you the director or shareholder of any companies?*

Yes
No

Confirmation

I confirm that the above information is complete and correct.*

I confirm

Terms and Conditions

Important Notice To Applicant(s) For Credit (Section 18(E)(c) Privacy Act 1988) Notice of disclosure of your credit information to a credit-reporting agency. (Privacy Act 1988)

Nationwide Capital Pty Ltd. may give information about you to a credit reporting agency, for the following purposes: - to obtain a consumer credit report about you, and/or - to allow the credit reporting agency to create or maintain a credit information file containing information about you.The information is limited to: - identity particulars – your name, sex, address ( and the previous two addresses) date of birth, name of employer, and drivers licence number. - your application for credit or commercial credit – the fact that you have applied for credit and the amount. - the fact that Nationwide Capital Pty Ltd. is a current credit provider to you. - advice that your loan repayments are no longer overdue in respect of any default that has been listed. - information that, in the opinion of Nationwide Capital Pty Ltd. you have committed a serious credit infringement (that is, fraudulently or shown an intention not to comply with your credit obligations). - dishonoured cheques – cheques drawn by you for $100 or more which have been dishonoured more than once. - that credit provided to you by Nationwide Capital Pty Ltd. has been paid or otherwise discharged.

Period to which this understanding applies

This information may be given before, during or after the provision of credit to you.

Statement By Applicant(s) For Credit

Please read carefully before signing. Where there is more than one applicant, each applicant must sign.

1. Giving information to a Credit Reporting Agency (Section 18E(8)(c) Privacy Act 1988)

Nationwide Capital Pty Ltd. has informed me that it may give certain personal information about me to a credit-reporting agency.

2. Access to Commercial Credit Information (Section 18L(4) Privacy Act 1988)

I/We agree that Nationwide Capital Pty Ltd. may obtain information about me/us from a business, which provides information about the commercial credit worthiness of persons for the purpose of assessing my/our application for consumer credit.

3. Access to Consumer Credit Information (Section 18K(1)(b) Privacy Act 1988)

I/We agree that Nationwide Capital Pty Ltd. may obtain a consumer credit report containing information about me from a credit-reporting agency for the purpose of assessing my/our application for commercial credit.

4. Exchange of Credit Worthiness Information (Section 18N(9) Privacy Act 1988)

I/We agree that Nationwide Capital Pty Ltd. may exchange information with those credit providers named in this application or named in a consumer credit report issued by a credit reporting agency for the following purposes; - to assess an application by me/us for credit

Agreement*

I agree to the terms and conditions

CALL: 02 9223 7181

Individuals

Individual Applicant 1

Individual Applicant 2

Company / Trust

Advisor Details

Solicitor

Accountant

Details of loan required

Security offered for the loan

Property 1

Property 2

Personal Financial Statements

Liabilities

Assets

Statement by borrower/s

Confirmation

Terms and Conditions

Important Notice To Applicant(s) For Credit (Section 18(E)(c) Privacy Act 1988) Notice of disclosure of your credit information to a credit-reporting agency. (Privacy Act 1988)

Period to which this understanding applies

Statement By Applicant(s) For Credit

1. Giving information to a Credit Reporting Agency (Section 18E(8)(c) Privacy Act 1988)

2. Access to Commercial Credit Information (Section 18L(4) Privacy Act 1988)

3. Access to Consumer Credit Information (Section 18K(1)(b) Privacy Act 1988)

4. Exchange of Credit Worthiness Information (Section 18N(9) Privacy Act 1988)

02 9223 7181

Contact Us

Popular Posts

Login Status