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Applicant Details & Declaration

Privacy Act Authorisation Agreements

Statement on the Use of Your Personal Information

Privacy Act 1988

IntelliLend may submit loans through our broker network in brokering your mortgage, personal loan or other type of finance. We are covered by the Privacy Act 1988, which came into operation on 21 December 2001.

In accordance with our obligations under the Privacy Act, this document advises you of the manner in which your personal information is handled by IntelliLend.

We respect the privacy of your personal information.

You have consented to IntelliLend disclosing the information on your application form, to a lender for the purposes of obtaining finance.

We have collected your personal information in order to complete the application for finance. If you do not provide all of the required information, the application may not be considered for approval. IntelliLend keeps a copy of your application in order to communicate with you about the application, and provide other services to you. You have a right to access this information, in accordance with the Privacy Act. If you wish to exercise your right of access, please contact “admin reception (03) 9820 3222.”

Electronic and Other Communications

IntelliLend may communicate with you about your application for finance, other advices which may be of interest to you and general information about personal loans, commercial loans and other forms of finance.

Referral of Your Information to Other Service Providers

As discussed with you, IntelliLend is pleased to provide you with our other services and also to refer you to other service providers for the purposes of discussing and securing insurance or other financial products. If you do not consent to such a referral and our forwarding your information only to the service providers discussed with and approved by you, please tick this box

 I have read and accept the privacy statement.
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Section 1: Applicant details and declaration

Personal Details

Loan Amount*

Purpose*

Title*

Surname*

Given Name*

Gender*

Date of Birth*

Martial Status*

Number of Dependants*

Age*

Address Home*

Suburb*

State*

Postcode*

Home Phone

Mobile Number*

Work Phone

Residential Status*

Period of Residence*

Real Estate / Mortgagee*

Address

if less than 5 years, please state previous address

Period of Residence

Previous residence

Driver's License Number*

License Exp*

State*

Deposit / Trade in Details*

For Payg Applicants

Employer Name

Phone Number

Employer Address

Suburb

Postcode

Employer Status

Occupation

Contact Name

Start Date

End Date

Industry

Salary (Annually)

A.B.N. (If Applicable)

Previous employment if in current job less than 5 years

Employer Name

Phone Number

Employer Address

Suburb

Postcode

Employment Status

Occupation

Start Date

End Date

Contact Name

Industry

Salary (Annually)

For Self-Employed Applicants

Select

 Individual / Sole Trader or Partnership Company

ABN / ACN

Trading / Business Name

Business Address

Suburb

Postcode

Landline

Mobile Number

Fax

Industry

Year Established

Gross Profit 08-09$

Net Profit 08-09$

Gross Profit 07-08$

Net Profit 07-08$

Director Name

Section 2 : Personal Reference

Personal Reference 1

Name*

Address*

Phone Number*

Relationship to you*

Personal Reference 2

Name

Address

Phone Number

Relationship to you

Personal Reference 3

Name

Address

Phone Number

Relationship to you

Section 3: Statement of assets and liabilities

Liabilities

Mortgage / Rent

Personal Loan

Motor Vehicle

Credit Card 1

Credit Card 2

Tax Owed

Other (Please Specify)

Assets

Land and Buildings

Address of Property

Motor Vehicle

 

Household contents

Cash at Bank

Superannuation

Shares / Bonds

Insurance

Other

Declarations

Q1 : Do you have any past debts to any financial institution or have had any legal proceedings taken against you for debt?

 Yes No

Q2 : Have you ever been declared bankrupt or insolvent or petitioned for bankruptcy?

 Yes No

Q3 : Have you ever been a shareholder or officer of any private company of which an administrator, receiver, manager and/or liquidator have been appointed or had a petition for winding up?

 Yes No

Q4 : Have you ever applied for finance under a different name?

 Yes No

If you have answered yes to any of the questions above, please provide explanation below: