Download Borrower Income Declaration

Originator ID (OID)
401______________________Broker ID (BID) ______________________________
Brokerage fee
$________________________Full application fee $__________________________
Application no (AID)
___________________________________
Tell us your story
Applicant 1
M
Full name
F
Date of birth
Married
Single
/
Defacto
Current address
/
Years
Home ph
( )
Mobile
Renting
Mortgaged
State
P/C
Own
Previous address
Years
Renting
(if less than 3 years at current address)
Mortgaged
State
Own
P/C
Current occupation & employer
Years
Work ph (
Years
Phone
( )
)
(if Self Employed, ABN required)
Full time
Part time
Casual
Self
Previous occupation & employer
Full time
Part time
Casual
Drivers licence no.
Self
Age of dependants
Email address
Details of nearest living relative not residing with you
Name: _______________________________ Phone: (
Salary
Family allowance
Existing rents
Other income
) __________ Address: __________________________________________________
Weekly
Fortnightly
Monthly
Yearly
Weekly
Fortnightly
Monthly
Yearly
Weekly
Fortnightly
Monthly
Yearly
Weekly
Fortnightly
Monthly
Yearly
$
$
$
$
Applicant 2
M
Full name
F
Home ph
( )
Date of birth
Married
Single
/
Defacto
Current address
Mobile
/
Years
Renting
Mortgaged
State
P/C
Own
Previous address
Years
Renting
(if less than 3 years at current address)
Mortgaged
State
Own
P/C
Current occupation & employer
Years
Work ph
( )
Years
Phone
( )
(if Self Employed, ABN required)
Full time
Part time
Casual
Self
Previous occupation & employer
Full time
Part time
Casual
Self
Drivers licence no.
Age of dependants
Email address
Details of nearest living relative not residing with you
Name: _____________________________ Phone: (
Salary
Family allowance
Existing rents
Other income
) __________ Address: _________________________________________________
Weekly
Fortnightly
Monthly
Yearly
Weekly
Fortnightly
Monthly
Yearly
Weekly
Fortnightly
Monthly
Yearly
Weekly
Fortnightly
Monthly
Yearly
$
$
$
$
Address of property to be purchased / security offered
Estimated value
Postcode
$
Estimated value
Postcode
$
Total security
$
Address of additional security offered
Solicitor’s name:
Phone: (
)
Finance purpose (please specify in detail)
Details
Split 1
Purchase
Split 2
Refinance
Purchase
Split 3
Refinance
Purchase
Split 4
Refinance
Purchase
Refinance
Type of finance
Construction
LOC
Principal & Profit
Construction
LOC
Principal & Profit
Construction
LOC
Principal & Profit
Construction
LOC
Principal & Profit
Repayments
Profit only (term
Finance amount
yrs)
$
Profit only (term
yrs)
$
Profit only (term
yrs)
$
Profit only (term
yrs)
$
Finance product
Profit rate
%
Finance term
%
years
Total Finance(s)
%
years
$
%
Years
LVR
%
years
Assets
Land & buildings
1.
Value
Mortgages
1.
$
2.
Financial
Institution
Monthly
repayments
Amount
owing
$
$
$
$
$
$
$
$
$
$
2.
$
3.
3.
$
Motor vehicles
Hire purchase
1.
1.
$
2.
2.
$
Saving Account/Cheque Account/Cash
$
Overdraft
$
$
Total deposit(s) paid
$
Credit card limit
$
$
Home Contents
$
Personal loans
$
$
Superannuation
Rental expense
$
$
Other assets
HECS
$
$
Other loans (please
specify)
$
$
$
$
1.
$
1.
2.
$
2.
Total assets
$
Total liabilities
$
Surplus (Total assets minus total liabilities) $
Do you know of any foreseeable significant changes to your circumstances or anything else that may reasonably be expected to have a bearing on your application for
finance that will lead to changes in your ability to make contracted payments under the proposed finance without difficulty?
NO
YES Please provide details:
PRIVACY CONSENT FORM
By signing this document you consent to us and some other entities collecting, using, holding and disclosing personal and credit information about you. You can find out more
about how we deal with your privacy by viewing our privacy policy at www.mcca.com.au. If you do not provide us with this consent or provide us with your personal
information we may not be able to arrange finance for you or provide other services.
We arrange and manage finance. Some of the funders we use are listed at the end of this consent. In this consent, ‘we’ includes us and those funders. We may collect, use,
hold and disclose personal and credit information about you for the purposes of arranging or providing finance to you, managing that finance, direct marketing of products and
services by us and managing our relationship with you.
Credit information includes the type and amount of finance provided to you, repayment history information, default information (including overdue payments) and court
information. Personal information includes any information from which your identity is apparent.
You may gain access to the personal information that we hold about you by contacting us. A copy of our privacy policy can be obtained at www.mcca.com.au or by
contacting us on 1300 724 735. The link to the privacy policy for our funders is shown at the end of this consent. These privacy policies contain information about how you
may access or seek correction of your personal information and credit information, how we manage that information and our complaints process. They also contain
information on ‘notifiable matters’ including things such as the information we use to assess your creditworthiness, what happens if you fail to meet your credit/finance
obligations or commit a serious credit infringement, your right to request that credit reporting bodies (CRBs) not use your credit information for the purposes of pre-screening
credit offers, and your right to request a CRB not to use or disclose credit information about you if you believe you are a victim of fraud.
Consumer and commercial finance information. We may exchange your commercial and consumer finance information with entities listed below to assess an application
for consumer or commercial finance and manage that /finance. In particular, we can obtain finance information about you from a CRB providing both consumer and
commercial finance information.
Exchange information with finance providers. We may exchange your personal and credit information with other finance providers for the purposes of assessing your
creditworthiness, credit standing, and credit history or credit capacity.
Exchange information with guarantors. We and the funders mortgage insurers listed below may exchange your personal and credit information with any person who
proposes to guarantee or has guaranteed repayment of any credit/finance provided to you.
Exchange information. We may exchange personal and credit/finance information with the following types of entities, some of which may be located overseas. Please see
our privacy policy for more information.
•
Finance brokers, mortgage managers, and persons who assist us to provide our products to you
•
Financial consultants, accountants, lawyers and advisers
•
Any industry body, tribunal, court or otherwise in connection with any complaint regarding the approval or management of your finance – for example if a complaint
is lodged about us or the funder
•
Businesses assisting us with funding for finance
•
Trade insurers
•
Any person where we are required by law to do so
•
Any of our associates, related entities or contractors
•
Your referees, such as your employer, to verify information you have provided
•
Any person considering acquiring an interest in our business or assets
•
Any organisation providing online verification of your identity
Customer identification. We may disclose personal information about you to an organisation providing verification of your identity, including on-line verification of your
identity.
Funders Mortgage Insurers. We may exchange personal and credit information with the funders mortgage insurers listed below. The funders mortgage insurers may
exchange your personal and credit information with third parties including the CRBs listed below, and the other entities with whom we can exchange information.
The funders mortgage insurers hold, use and disclose your personal information and credit/finance information for the purposes of assessing whether to provide insurance to
us, including to assess the risk of you defaulting or the risk of a guarantor being unable to meet their liability, managing the insurance, and verifying personal information
provided by us or any purpose under the insurance contract. If you don’t provide personal information to the finance provider, it will not be possible for the funders mortgage
insurers to process the finance provider’s request for mortgage insurance.
The LMIs that we may disclose your personal information and credit information to are:
Genworth Financial Mortgage insurance Pty Ltd who can be contacted and a copy of the privacy policy obtained on 1300 655 422 or genworth.com.au; and
QBE Lenders Mortgage insurance Limited who can be contacted and a copy of their privacy policy obtained on 1300 367 764 or qbelmi.com.
Funders we may use include First Mortgage Company Home Loans Pty and a copy of their privacy policy obtained on www.firstmac.com.au/privacy-policy
The privacy policies of the funders mortgage insurers and funders contain information about how you may access the personal information and credit information those
entities hold about you, seek correction of that information, and how you may complain about a breach of your privacy.
The funders mortgage insurers and funders may disclose your personal and credit information to overseas entities including related entities located overseas including in
USA, Canada and the United Kingdom.
More information on overseas disclosure may be found in the entities’ privacy policies.
We may exchange your personal and credit information with the following credit reporting bodies:
Veda Advantage Ltd - veda.com.au
Dun & Bradstreet (Australia) Pty Ltd - dnb.com.au
Experian - experian.com.au
Signatures of Applicant(s) and date
You consent to the use of your personal and finance information as set out above.
Name
Name
Signature
Signature
Date
Date
Declaration by Introducer or Introducer’s Agent: I declare that I have sighted and validated and/or will sight and validate all the original documents of all
copies of documents associated with this finance application forwarded or to be forwarded to FirstMac Mortgage Management Limited (“FirstMac”) and I declare
that I have given to the Applicant/s / Guarantor/s a copy of the FirstMac Personal Information Collection Statement and relevant Comparison Rate Schedule.
Introducer Name: __________________________________________________
Signed: _________________________________________________________________
Dated ___/___/___
Section 1: Joint nomination form
Each applicant is separately entitled under the National Credit Code to receive a copy of any notice or other document
under the National Credit Code.
This form may be signed by joint applicants who wish to nominate one of them as the person who will receive notices
and other documents relating to the finance (so that they don’t have to each receive their own copy of any notices and
other documents).
By signing below, you give up the right to be provided with information direct from the Funder, and nominate one of you
to receive this information.
Nomination
I / We nominate ___________________________________________________ (full name of person nominated) to
receive notices and other documents under the National Credit Code on behalf of me / all of us.
Only a person who is an Applicant may be nominated. Any Applicant who has signed this form can advise the Funder at any time in
writing that they wish to cancel their nomination. Following any cancellation, the Funder will from then on provide each joint Applicant
with their own separate copy of any notice or other document under the National Credit Code.
Signed: _____________________________________________________________ Dated: ______/ ______/ ______
Full name: ______________________________________________________________________________________
Signed: ______________________________________________________________ Dated: ______/ ______/ ______
Full name: ______________________________________________________________________________________
Section 2: Declaration as to purpose of credit
I / We declare that the credit to be provided to me / us by the credit provider is to be applied wholly or predominantly for
business or investment purposes other than investment in residential properties (or for both purposes)
IMPORTANT
You should not sign this declaration unless this finance is wholly or predominantly for business or investment purposes
other than investment in residential properties.
By signing this declaration you may lose your protection under the National Credit Code
Signed: _____________________________________________________________ Dated: ______/ ______/ ______
Full name: ______________________________________________________________________________________
Signed: _____________________________________________________________ Dated: ______/ ______/ ______
Full name: ______________________________________________________________________________________
Customer identification checklist
Anti-Money Laundering & Counter Terrorism Financing Act 2006
Part 2 of the Anti-Money Laundering & Counter Terrorism Financing Act 2006 requires the information in this form to be collected and verified for EACH borrower, guarantor or company / trust / trustee associated with
this loan application as shown in the “Tell us your story” loan application form. Where you are the introducer of the loan please ensure that you follow the relevant lender's procedures.
Applicant’s full name:
select one
Individual
Guarantor
Director
Trust / Trustee
Application ID:
Customer – Individual (one form to be completed for EACH person associated with this application)
Instructions for completion
• You must arrange for a prescribed person to complete this form
• You must be in the prescribed person’s presence when you sign the form
• You will need to show the prescribed person the original identification
documents
• Return the completed form and copies of the identification documents
certified by the prescribed person to Firstmac
• Please complete one form for each individual associated with this
application
Declaration (by prescribed person)
I declare I have examined the original document(s) and verify the individual's name and either residential address or date of birth as true and correct from:
1 x Primary Photographic Identification
or
2 x Primary Non Photographic Identification
or
1 x Primary Non Photographic and 1 x Secondary Identification
(Individual’s full name)
(Individual’s date of birth)
/
Belonging to
/
(Common other names, if relevant, e.g. maiden name, anglicised name etc.)
Who is also commonly known by the name(s) of
and who resides at (PO Box is not acceptable)
State
Signature of person being identified
Postcode
Date:
/
/
Acceptable Identification Standard
Primary Photographic Identification (sufficient ID by itself)
• Australian Passport, which has not been expired for more than two years
• Australian Drivers Licence (current)
• Drivers licence issued by a foreign government which contains a photo
• Australian Govt issued Proof of Age Cards (All States)
• International Passport/Travel Document/National Identity Card issued
for the purpose of identity which; contains a photograph and signature
of the person in whose identity the document is issued; is issued by a
foreign government, the United Nations (UN) or an agency of the
United Nations (UN); and, if written in a language other than English
accompanied by an English translation from an accredited translator
Primary Non Photographic Identification
• Australian Birth Certificate or extract
• Birth certificate issued by a foreign government, the United Nations
(UN) or an agency of the United Nations (UN) if written in a language
other than English accompanied by an English translation from an
accredited translator
• Australian Government issued Citizenship certificate
• Certified citizenship issued by a foreign government if written in a
language other than English accompanied by an English translation
from an accredited translator
• A pension card issued by Centrelink that entitles that person whose
name the card is issued, to financial benefits
Secondary Identification
• A notice that was issued by the Commonwealth, State or Territory
within the last 12 months which; contains the name of the person and
his or her residential address: and; records the provision of financial
benefits to the individual under a law of the Commonwealth, State or
Territory
• Australian Tax Assessment Notice dated within the last 12 months
which contains the name of the individual and his or her residential
address
• A notice that was issued within the last 3 months by a local
government or public utility bill e.g. gas, electricity, water, rates
and contains the applicant’s name and his or her residential address
Form certification
This form can be completed by any of the following - a solicitor, a justice of the peace, a notary public, a serving police officer, an Australian consular or diplomatic
officer, an agent or permanent employee of Australia Post supplying postal services to the public, one of the following with two or more continu-ous years of service:
a finance company officer, an accountant, an officer or authorised representative of a holder of an Australian Financial Services
Licence or Australian Credit Licence, officer with a financial institution.
I certify: I have sighted the original documents used to identify the individual and the documentation provided is current or within acceptable time frames.
All photographic identification is a “reasonable likeness” to the individual. Nothing in my dealings with the individual has raised any suspicions concerning
the proposed transaction. Face to face verification of the individual was carried out by me.
Name of prescribed person:
Signature:
Occupation:
Address:
MFAA/FBAA AML/CTF Certification No:
Daytime phone:
The individual being identified signed this document in my presence on:
Note: It is an offence under the Anti-Money Laundering and Counter-Terrorism Financing Act 2006
for the applicant or prescribed person to make a false or misleading statement.)
Firstmac Limited ABN 59 094 145 963. Australian Credit Licence 290600
Prescribed person’s authenticating stamp:
/
/
Customer identification checklist
Anti-Money Laundering & Counter Terrorism Financing Act 2006
Part 2 of the Anti-Money Laundering & Counter Terrorism Financing Act 2006 requires the information in this form to be collected and verified for EACH borrower, guarantor or company / trust / trustee associated with
this loan application as shown in the “Tell us your story” loan application form. Where you are the introducer of the loan please ensure that you follow the relevant lender's procedures.
Applicant’s full name:
select one
Individual
Guarantor
Director
Trust / Trustee
Application ID:
Customer – Individual (one form to be completed for EACH person associated with this application)
Instructions for completion
• You must arrange for a prescribed person to complete this form
• You must be in the prescribed person’s presence when you sign the form
• You will need to show the prescribed person the original identification
documents
• Return the completed form and copies of the identification documents
certified by the prescribed person to Firstmac
• Please complete one form for each individual associated with this
application
Declaration (by prescribed person)
I declare I have examined the original document(s) and verify the individual's name and either residential address or date of birth as true and correct from:
1 x Primary Photographic Identification
or
2 x Primary Non Photographic Identification
or
1 x Primary Non Photographic and 1 x Secondary Identification
(Individual’s full name)
(Individual’s date of birth)
/
Belonging to
/
(Common other names, if relevant, e.g. maiden name, anglicised name etc.)
Who is also commonly known by the name(s) of
and who resides at (PO Box is not acceptable)
State
Signature of person being identified
Postcode
Date:
/
/
Acceptable Identification Standard
Primary Photographic Identification (sufficient ID by itself)
• Australian Passport, which has not been expired for more than two years
• Australian Drivers Licence (current)
• Drivers licence issued by a foreign government which contains a photo
• Australian Govt issued Proof of Age Cards (All States)
• International Passport/Travel Document/National Identity Card issued
for the purpose of identity which; contains a photograph and signature
of the person in whose identity the document is issued; is issued by a
foreign government, the United Nations (UN) or an agency of the
United Nations (UN); and, if written in a language other than English
accompanied by an English translation from an accredited translator
Primary Non Photographic Identification
• Australian Birth Certificate or extract
• Birth certificate issued by a foreign government, the United Nations
(UN) or an agency of the United Nations (UN) if written in a language
other than English accompanied by an English translation from an
accredited translator
• Australian Government issued Citizenship certificate
• Certified citizenship issued by a foreign government if written in a
language other than English accompanied by an English translation
from an accredited translator
• A pension card issued by Centrelink that entitles that person whose
name the card is issued, to financial benefits
Secondary Identification
• A notice that was issued by the Commonwealth, State or Territory
within the last 12 months which; contains the name of the person and
his or her residential address: and; records the provision of financial
benefits to the individual under a law of the Commonwealth, State or
Territory
• Australian Tax Assessment Notice dated within the last 12 months
which contains the name of the individual and his or her residential
address
• A notice that was issued within the last 3 months by a local
government or public utility bill e.g. gas, electricity, water, rates
and contains the applicant’s name and his or her residential address
Form certification
This form can be completed by any of the following - a solicitor, a justice of the peace, a notary public, a serving police officer, an Australian consular or diplomatic
officer, an agent or permanent employee of Australia Post supplying postal services to the public, one of the following with two or more continu-ous years of service:
a finance company officer, an accountant, an officer or authorised representative of a holder of an Australian Financial Services
Licence or Australian Credit Licence, officer with a financial institution.
I certify: I have sighted the original documents used to identify the individual and the documentation provided is current or within acceptable time frames.
All photographic identification is a “reasonable likeness” to the individual. Nothing in my dealings with the individual has raised any suspicions concerning
the proposed transaction. Face to face verification of the individual was carried out by me.
Name of prescribed person:
Signature:
Occupation:
Address:
MFAA/FBAA AML/CTF Certification No:
Daytime phone:
The individual being identified signed this document in my presence on:
Note: It is an offence under the Anti-Money Laundering and Counter-Terrorism Financing Act 2006
for the applicant or prescribed person to make a false or misleading statement.)
Firstmac Limited ABN 59 094 145 963. Australian Credit Licence 290600
Prescribed person’s authenticating stamp:
/
/
Amlak Commitment Schedule
By signing below I/we acknowledge and agree that:
(a)
A Commitment Fee of $790 is payable in respect of this request to the finance facility. The $790 consists of an application fee of
$345, Funder Processing Fee of $210 and $235 Valuation fee.
(b)
The application fee of $345.00 and Funder Processing Fee of $210 is payable irrespective of whether, the finance facility is declined
or approved. If a valuation has been completed the Valuation fee of $235 becomes payable irrespective of whether, the finance
facility is declined or approved.
(c)
I/we agree to pay the Commitment Fee as follows:
(i)
As soon as an application is lodged with MCCA Limited. I/we authorise MCCA Limited to debit the Commitment Fee to
my/our credit card account or bank account, the details of which appear below; or
Applicant 1:
Signed: _________________________________________________________________ Date: _____ / _____ / _____
Full name: __________________________________________________
Applicant 2:
Signed: _________________________________________________________________ Date: _____ / _____ / _____
Full name: __________________________________________________
Authority to debit Fixed Rate Fee to Credit Card Account
By signing below, I / we authorise MCCA Limited to debit the Commitment Fee to my / our credit card account in accordance with this request. The
merchant will be listed on a credit card account statement as “MCCA Limited”. I/we acknowledge I/we may request a receipt for a debit to my/our credit card
account under this authority by MCCA Limited on 1300 734 724. Please note that a 3.5% surcharge is charged on all credit card transactions and we
do not accept American Express or Diners Club credit cards.
Full Name and address (not a post box) of Card
Holder
Card number
Card expiry date
/
Please debit my
Visa
must be at least 3 months after the date of this
request.
MasterCard
Card Valid From
/
CCV
MCCA may collect information about a cardholder from a transaction in order to process the transaction.
The Cardholder may request access to that information. Please contact MCCA on 1300 734 724 for the Bank’s contact details.
Card Holder’s Signature
Bank Account Details
Bank
Branch
BSB No.
_____ _____ _____ - _____ _____ _____ (always six numbers)
Account No.
_____ _____ _____ _____ _____ _____ _____ _____ _____ (maximum nine numbers)
Bank Account Title
All Account Holders, Applicants and Guarantors to Sign (If signing for a company, please note under your signature if Director, Secretary, Sole Director)
Signature
Signature
X
Date
X
Date
_____/_____/_____
_____/_____/_____