Apply - Flexicredit Aus

Application Form

Apply online now for a fast approval. Your application will be reviewed immediately and a response provided within 24-48 hours. If you have any questions contact us on 1300 652 008

Applying for

Title

First name

Last name

Date of Birth

Drivers Licence Number

Drivers Licence Expiry

Phone No.(Mobile)

Ph.(Work)

Email Address

Street Address

Suburb

State

Postcode

How long have you lived at this address

Current Residential Status

If less then 3 years at current address please list previous

how much do you pay?

Frequency

Weekly

Fortnight

Month

Agent/Landlord/Mortgagee's Name

Agent/Landlord/Mortgagee's Address

Contant Phone Number

Marital Status

Number of Dependants

Spouse/Partner Name

Does your Spouse/Partner Contribute to the household expenses?

Yes No

Application Form

income & employment details

Current Employment

Company Name

Street Address

Suburb

State

Postcode

Phone Number

Job Title

Start Date

Hours Per Week

Weekly Pay

Previous Employment

Company Name

Street Address

Suburb

State

Postcode

Phone Number

Job Title

Length Employment

two contacts not living with you

Person 1

Full Name

Relationship

Street Address

Suburb

State

Postcode

Mobile Number

Alternate Number

Person 2

Full Name

Relationship

Street Address

Suburb

State

Postcode

Mobile Number

Alternate Number

Application Form

banking details

Name of Bank

Street Address

Suburb

State

Postcode

BSB

Account Number

assets

Household goods($)

Cars ($)

House & Land ($)

Other ($)

liabilities

Company

Balance

Repayments

Personal Loans

Car Loans

Mortgages

Credit Cards

Other Loans

summary of income & expenditure

Income - Weekly

Expenditure - Weekly

Wages / Salary

Rent / Mortgage / Board

Gov. Benefits

Household Expenses

Other

All Combined Loans

Total Credit Card Limits

Child Support

Any Other Expenses

Total Income ($)

Total Expenses ($)

Application Form

credit history

Have you ever been Bankrupt / Part |X Agreement(Please Tick)

Yes No

Have any of your loans been in arrears? (Please Tick)

Yes No

If Yes, Please specify when and current status

Are there any judgement or legal proceedings against you (Please Tick)

Yes

privacy consent

I authorise Flexi Credit to verify the information provided on this form as to my credit, employment and residential history.

"We/Us" means Flexi Credit, ACN 623 275 052, Australian Credit License Number 505 986 and its related entities. "You/I" is the person whose name appears on the application.

Flexi Credit and its related entities may collect and use your personal information for arranging or providing credit, enforcing our rights under any loan contract facility, insuring credit and for direct marketing of products and services offered by us or any organisation we are affiliated with or represent. You have the right to request not to receive direct marketing material. Please check if you DO or DO NOT wish to receive marketing information from Flexi Credit Aus, its related entities and its preferred alliance organisations.

The Commonwealth Privacy Act 1988, as amended, the Commonwealth Privacy Regulations 2013, and the Credit Reporting Privacy Code 2014 empower and regulate Flexi Credit Austarlia in accordance with the following

declaration

I hereby declare that:
a) I have read the section entitled "Privacy Consent". b) This is an application only and that Flexi Credit is not obligated to give me credit. c) I am not known by any other name(s). d) I will provide all necessary information as requested for identification and verification under the Anti-Money Laundering & Counter Terrorism Financing Act 2006. e) All information contained in this application is true and correct. f) I authorise my employer or accountant to disclose any salary, employment or financial details to Flexi Credit to assist in the assessment of this application.

By ticking this box and printing you name you agree to the terms and conditions of the the privacy form This field is required.

Name

Date

Signature