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By completing the following application form with as much detail as possible, a Aussie Loans Online - team member will assess your details and contact you directly at your specified time.

Privacy Act 1988 Consent Form (for use by Applicant)

I/We acknowledge that in accordance with s.18E(8)(c) of the Privacy Act 1988, certain items of personal information about me/us contained in this application and permitted to be kept on a credit information file, might be disclosed to a credit reporting agency.

The Applicant or Applicants (hereinafter referred to as “me/us”) agree and authorise that in connection with this application for credit, Loan Me Australia Pty Ltd - its staff/website and/or any associated Credit Provider may do all the things set out below.

Seek and use commercial credit information about me/us to assess an application for consumer credit (S. 182(4)).
Seek and use consumer credit information about me/us to assess an application for commercial credit (S. 18K(1)(b)).
Use a credit report about me/us provided by a credit reporting agency to collect overdue payments from me/us (S. 18K(1)(L)).
Provide information to a trade insurer or mortgage insurer to assess the risk of default by me/us (S.18K(1)(e)).
Seek from or give to another credit provider any information about my/our credit worthiness, credit standing, credit history or credit capacity (S18N(1)(b),(f)).

I/WE AGREE AND CONSENT TO THE ABOVE TERMS, CONDITIONS AND PRIVACY ACT AND UPON SUBMISSION OF APPLICATION FORM CONSENT AUSSIELOANSONLINE TO NEGOTIATE FOR A PERSONAL LOAN ON MY/OUR BEHALF.

1. Loan Purpose & Loan Amount

Purpose of Loan:

Loan Amount:

$ (used to calculate fee)

Preferred Contact Time:

2. Applicant Details:

Title:

First Name:

Surname:

Date of Birth:

Marital Status:

Dependents:

Email Address:

Drivers Licence No:

Home No:

Mobile No:

Work No:

Address:

Suburb / Post Code:

Time at Residence:

Residential Status:

If paying rent/board/mortgage:

$ per month

If you have lived in your current address for less than 3 years, what was your previous address:

Address:

Suburb / Post Code:

Time at Residence:

3. Employment Details:

Occupation:

Employment Status :

Date commenced :

Employer Business Name :

ABN Number:

Employer Address :

Suburb / Post Code :

Employer contact name :

Employer contact number :

Employer address must be as found in white pages and contact number must be landline no mobile numbers.

4. Bank Details:

What bank accounts do you currently have?

	Bank	Branch	BSB	Account Number:.	Latest Balance
eg.					$
					$
					$
					$

5. Income Details:

Please list all your incomes, including wages, rent, dividends, pensions etc

	Income type	Frequency	Gross	Nett (Take home pay)
eg.			$	$
			$	$
			$	$
			$	$
			$	$

6. Assets :

	Type of Asset	Description	Value
eg.			$
			$
			$
			$
			$
			$
			$

If you listed a car, boat, bike or caravan etc in Assets, please complete:

Make:

Model:

Year:

Is the vehicle under finance:

7. Liabilities :

Include your mortgage and any other loans/debts ie credit, store cards.

	Type	Lender	Initial Amount	Amount Owing	Re- payment	Limit	Are we paying this out from a new loan?
eg:			$	$	$	$
			$	$	$	$
			$	$	$	$
			$	$	$	$

Late Payments/Defaults/Arrears :

Any loan defaults?

Do you have good credit history?

Are you currently legally bankrupt?

No Yes

8. Next of Kin:

(Emergency contact only, contact must NOT be living with you.)

First Name:

Surname:

Address:

Suburb / Post Code:

Daytime Contact No.:

9. Fee Agreement:

I agree to allow AussieLoansOnline ( Loan Me Australia Pty Ltd) to ascertain my eligibility for a Personal Loan on the conditions below:

Loan Amount:

Term of Loan:

I have read all of the terms and conditions above and agree to be bound by them.

I/we understand that by submitting this application agree and consent to the above terms, conditions and privacy act and upon submission of application form consent AussieLoansOnline to negotiate for a personal loan on my/our behalf.

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