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Loan Details

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About you

Assets

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Worth
$
$
$
Balance Owing
$
$

Income

Yourself
$
Spouse / Partner
$
Your professional informations

Debts

Bank
Owing
$
$
$
$
$
$
$
Max Limit
$
$
$
$
Worth
$

Savings

$
Your professional informations

Authority to CreditBlueShield under the Privacy Act

DECLARATION

FINANCE BROKER PRIVACY CLAUSES CreditBlueShield ACN: 605 753 008
Important Notice To Applicant(s) For Credit (Section 18(E) (1) Privacy Act 1988)
Notice of disclosure of your credit information to a credit-reporting agency. (Privacy Act 1988)

CreditBlueShield may give information about you to a credit reporting agency, for the following purposes:

•    To obtain a consumer credit report about you, and/or
•    To allow the credit reporting agency to create or maintain a credit information file containing information about you.

The information is limited to:

•    Identity particulars – your name, sex, address (and the previous two addresses), date of birth, name of employer and drivers licence number.
•    Your application for credit or commercial credit – the fact that you have applied for credit and the amount.
•    The fact that CreditBlueShield is a current credit provider to you.
•    Loan repayments which are overdue by more than 60 days, and for which debt collection action has started.
•    Advice that your loan repayments are no longer overdue in respect of any default that has been listed.
•    Information that, in the opinion of CreditBlueShield you have committed a serious credit infringement (that is, fraudulently or shown an intention not to comply with your credit obligations).
•    Dishonored cheques – cheques drawn by you for $100 or more which have been dishonored more than once.
•    That credit provided to you by CreditBlueShield has been paid or otherwise discharged.

Period to which this understanding applies
This information may be given before, during or after the provision of credit to you.

STATEMENT BY APPLICANT(S) FOR CREDIT

Please read carefully before signing. Where there is more than one applicant, each applicant must sign.

1.   Giving information to a Credit Reporting Agency (Section 18E(8)(c) Privacy Act 1988)CreditBlueShield has informed me that it may give certain personal information about me to a credit-reporting agency.

2.   Access to Commercial Credit Information (Section 18L(4) Privacy Act 1988)I/we agree that CreditBlueShield may obtain information about me/us from a business, which provides information about the commercial credit worthiness of persons for the purpose of assessing my/our application for consumer credit.

3.   Access to Consumer Credit Information (Section 18K(1)(b), Privacy Act 1988)I/we agree that CreditBlueShield may obtain a consumer credit report containing information about me from a credit-reporting agency for the purpose of assessing my/our application for commercial credit.

4.   Exchange of Credit Worthiness Information (Section 18N, Privacy Act 1988)I/we agree that CreditBlueShield may exchange information with those credit providers named in this application or named in a consumer credit report issued by a credit reporting agency for the following purposes;
•    to assess my/our credit worthiness.
•    to notify other credit providers of a default by me/us
•    to exchange information with other credit providers as to the status of this loan where I am in default with other credit providers
•    to assess my/our credit worthiness.
I/we understand that the information exchanged can include anything about my/our credit worthiness, credit standing, credit history or credit capacity that credit providers are allowed to exchange under the Privacy Act.

5.   Agreement to a credit provider being given a consumer credit report by a credit reporting agency to assess a guarantor (Section 18K 1(c) Privacy Act 1988)I/we agree the CreditBlueShield may obtain from a credit reporting agency a consumer credit report containing information about me/us for the purpose of assessing whether to accept me/us as a guarantor for credit applied for by, or provided to, the borrower(s) [named in agreement]. I/we agree that this agreement commences from the date of this agreement and continues until the credit covered by the borrower(s) application ceases.

6.   Agreement to a credit provider disclosing a report including a consumer credit report to potential or existing guarantor (Section 18K (1) Privacy Act 1988)I/we agree that CreditBlueShield may give to a person who is currently a guarantor, or whom I/we indicated is considering becoming a guarantor, a credit report containing information about me/us for the purpose of [name of prospective guarantor] deciding whether to act as a guarantor, or to keep [name of the existing guarantor] informed about the guarantee. I/we understand that the information disclosed can include anything about my/our credit worthiness, credit standing, credit history or credit capacity that credit providers are allowed to disclose under the Privacy Act, and includes a credit report.

Client Agreement

I hereby declare that all information that I have supplied to CreditBlueShield is true and correct at the time of filling in this form and should any circumstances change I will notify CreditBlueShield as soon as possible.
CreditBlueShield Pty Ltd will access your credit file.
I invite CreditBlueShield and your agents and your preferred alliance organizations to use my personal information for marketing purposes. This includes contacting me by telephone, mail or email to discuss and agree with any purchase of goods or services from CreditBlueShield Company or your products and of any third party providing products jointly marketed with CreditBlueShield. I understand that I can call 1900 997 777, or email info@creditblueshield.com, if I  want to withdraw this invitation and remove my name from your marketing list.

I acknowledge that I have read and agree to the Declaration:

Payment Method Processing Details

Your professional informations
And Fax or Email 100 points of ID from the list below to (02) 8040 4749
Passport
70 points
Birth Certificate
70 points
Citizenship Certificate
70 points
Drivers Licence
40 points
Medicare Card
25 points
Credit Card
25 points

Payment Method

Deposit $27 into ANZ Bank
Account Name :
CreditBlueShield
BSB:
012 281
Account Number:
196 588 933
Call 1900 997 777
Address to:
CreditBlueShield
Level 20, Tower 2, 201 Sussex St,
Sydney, NSW, 2000, Australia