Financing

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General

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Address

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Employment

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Financial Position

Assets Value (Please show the combined totals if more than one applicant):

Liabilities (Please show the combined totals if more than one applicant):

Income

Terms and Conditions

Please Provide us with any other information that will assist your application:

PRIVACY ACT 1993: I/We irrevocably authorise any person to provide you with such personal information concerning me/us as you may require in response to your credit and/or employment enquiries. I/We further irrevocably authorise you to furnish to any lender or third party any personal information concerning me/us including details of this application and any subsequent dealings that I/we have with you as a result of this application being action by you. I/We further authorise such lender or third party to make further enquiries (now or in the future) which may be necessary in connection with this application and any agreement I/we may enter into as a result of this application. Where the personal information may be readily retrieved, I/we shall have access to it and the right to request correction. I/We apply for the above loan and certify that the particulars supplied are true and correct, and that I/we are over the age of 18 years and I am/we are not an undischarged bankrupt.

I have read and accepted the terms and conditions:

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