Application Form

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Details
Full Name : *		Mobile  : *
Phone : *		Email : *
Address :
City :
State : *	ACT VIC QLD SA NSW WA	Postcode :
Date of Birth :
Marital Status :	Single Married Divorced Separated Defacto	No. Dependants :
Drivers License Type :	Open Provisional Leaner Suspended	Drivers Lisence No :
Drivers Lisence Expiry :

 

Living Arrangements
Living Arrangements :	Mortgage Owned Outright Renting Boarding/with parents	Amount You Pay Per Month :
Time At Current Address :		Time at Previous Address :

 

Employment Details
Employment Status :	Fulltime Casual Part time Permanent Part time Contractor Self-Employed Retired Pension Retired-self funded Unemployed	Gross Monthly Income :
Time At Current Employment :		Time at Prvious Employment :

 

Additional Information
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Preffered Contact Method :	Phone Email Fax	Preferred Contact Time :	Morning Noon Afternoon Evening
Additional Information :
NATIONAL FINANCE SOLUTIONS PRIVACY CONSENT NATIONAL FINANCE SOLUTIONS NATIONAL FINANCE SOLUTIONS A.B.N 47097743578 (“NFS”) collects from me/us (being each of the Applicants and Guarantors whose signature appears below) and from other persons, personal information about me/us, for the purpose of: • Assessing the application for finance, the guarantee and any related insurance proposal; • Arranging finance and insurance; and • Credit and reference checking For the same purpose, NFS will use this information and disclose it to: • One or more of the financiers used by NFS to arrange finance (including St George Automotive, GE Automotive & Esanda Financial Services), all of whom are collectively referred to as “Credit Providers” in this consent; and • (where relevant) any business which provides information about the creditworthiness of persons (“Credit Reporting Agency”), suppliers of goods, mercantile agents, collection agencies, insurers, and to NFS’s agents, contractors and external advisers and to my/our car or finance broker. I/We agree the NFS may disclose my/our personal information to its related bodies corporate and to it credit providers and the Related Companies may use this personal information for product development and research and in inform me/us about products and services in the future. NFS and the Related Companies will not send me information about products and services if I/we send a written request to that effect to NFS at the address below. I/We acknowledge that if we don not provide this information, NFS or the Credit Providers may not be able to process the application for finance. I/We are able to gain access to the information held about me/us by NFS and the Related Companies, subject to exceptions stated in the Privacy Act 1988 (CTH) (“the Privacy Act”). I/We agree that, if we supply NFS or the Credit Providers with personal information about any third party (such as a referee), I/we will inform that third party of this fact. The Credit Providers collect and use personal information about me/us for the following purposes: • Assessing the application for finance, the guarantee or any related insurance proposal; and • (if the application is accepted) Providing finance and ancillary services (such as insurance) to the Applicant(s) and for the ongoing management of the finance, guarantees and ancillary services. For those same purposes, and subject to the Privacy Act, I/we agree that the Credit Providers may do all the following now and in the future: 1. Collect and use commercial or consumer credit information about me/us from a Credit Reporting Agency. 2. Collect from and give to (i) any credit provider named in the application for finance or the information obtained under paragraph 1 above or (ii) any body which maintains a register of encumbered vehicles (such as R.E.V.S.), or (iii) a Credit Reporting Agency, any personal information about me/us, including any information about my/our creditworthiness, credit standing, credit history or credit capacity, the status of the finance and any default by me/us in accordance with the Privacy Act. 3. Collect from and give to any sources disclosed in the application for finance, personal information about me/us. 4. Give to any guarantor or proposed guarantor of the application for finance, any information about the finance (including personal information about me/us) now or at any time in the future. 5. Collect from and disclose personal information about me/us to the Credit Provider’s agents, contractors, external advisers as well as to suppliers of goods, mercantile agents, collection agencies and insurers, and my/our car or finance broker. The Credit Provider who provides me/us with finance may also seek my/our consent to other acts of collection, disclosure and use of personal information about me/us. In the Consent, “personal information” has the same meaning as in the Privacy Act and includes sensitive information (e.g. Health information). Declaration I/We solemnly and sincerely declare that: a) I am/We are not insolvent or an undischarged bankrupt; b) The information given by me/us is true and correct; c) The income and expenses declared represent an accurate assessment of my/our financial position; d) I am/We are permanent resident(s) of Australia; e) I am/We are over the age of 18 years: and f) I/We have read and understood this privacy Act Consent and agree to NFS, the Related Companies and the Credit Providers collecting, using and disclosing information (including personal information) about me/us in accordance with the provisions of this Consent. ………………………………………… ……………………………………….. Signature of Applicant / Guarantor Signature of Applicant / Guarantor ………………………………………… ………………………………………… Print Name of Applicant / Guarantor Print Name of Applicant / Guarantor Date ………………………………….. Date ………………………………… ……………………………………….. ……………………………………….. Signature of Applicant / Guarantor Signature of Applicant / Guarantor ………………………………………… ………………………………………… Print Name of Applicant / Guarantor Print Name of Applicant / Guarantor Date ………………………………… Date ………………………………… Contact Details National Finance Solutions Pty Ltd PO Box 1862, Cairns 4870 QLD Phone – 07 4081 5012 Fax – 07 4031 2041
I declare that i/We have read, understood and agree with the contents and references above.
I Agree
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