Broker Application Form

Transcription

Broker Application Form
For Office Use Only:
COMPLETED BY:
POSITION:
DATE:
Please Read This First…
1. Complete pages 1-16 of this form only. Do not complete any other pages before printing.
2. All lender forms are largely auto-populated with your details, however, there are some sections which need to
be completed and signed manually. Use the Broker Application Form - Guide to help you complete these
following sections.
3. The Supporting Documents Checklist states all the necessary supporting documents you will need to
become accredited or to transfer your existing accreditations to Finsure. Make sure you provide all of these
documents to ensure your application is processed as quickly as possible.
PERSONAL DETAILS
Broker Name
Title
First
Last
Home Address
City/Suburb
State
Postcode
Mobile
Work Phone
Fax
 Email
You can use your own email address or we can set up a new Finsure one for you. If you would like a new Finsure email
account, please use the format firstname.lastname@finsure.com.au when entering your chosen email address below.
My preferred email address is:
Drivers Licence No
State of Issue
Expiry Date
Date of Birth
Place of Birth
Please list any previous addresses within the last 5 years?
Previous 1
From/To
Previous 2
From/To
Previous 3
From/To
BROKER APPLICATION FORM
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Do You Have Any Previous Names?
Yes
No
Your Mother’s Maiden Name
Emergency Contact
Name
Tel
BUSINESS DETAILS
Business Name
Trading Name
Company or Sole Trader?
Company
Partnership
Sole Trader
ABN
ACN
Business Address
City/Suburb
State
Postcode
Postal Address (if different)
In Which State was Business Registered?
Current Primary Business Location (State)
Date Business Started
Registered for GST?
Yes
No
Date Registered for GST
DIRECTORS/PARTNERS
Please provide information for all Company Directors/Partners
Name 1
Title
First
Last
Title
First
Last
Title
First
Last
Home Address
Date of Birth
Place of Birth
Drivers Licence No
State of Issue
Expiry Date
Name 2
Home Address
Date of Birth
Place of Birth
Drivers Licence No
State of Issue
Expiry Date
Name 3
Home Address
Date of Birth
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Place of Birth
Drivers Licence No
State of Issue
Expiry Date
DETAILS OF GUARANTORS
Guarantor 1 Name
Home Address
Date of Birth
Place of Birth
Drivers Licence No
State of Issue
Expiry Date
Guarantor 2 Name
Home Address
Date of Birth
Place of Birth
Drivers Licence No
State of Issue
Expiry Date
LICENSING AND REGISTRATION
Please select EITHER of the following and complete the relevant details:
I am a Director/Employee of a company which has an ACL or I have an ACL in my own name
ACL No
ACL Name
OR
I will be a Credit Representative of an ACL holder/licensee.
Credit Rep No
 Don’t know your ACL or Credit Rep Number?
Search for ACL holders (licensees) or Credit representatives at http://www.asic.gov.au/asic/asic.nsf
On the right hand side of the page, select Professional Registers and search in the Representative or Licensee registers.
COSL / FOS Member No (EDR Scheme)
COSL
FOS
Member No
COSL / FOS Expiry Date
PI Insurer
Policy Number
Expiry Date
Total Sum Insured
MFAA / FBAA Member No
MFAA / FBAA Expiry Date
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HISTORY
Previous Aggregator (if Applicable)
Time with Aggregator
Reason for Leaving Aggregator
Number of Years Broking Experience
Main Business Activities
(e.g. Mortgage Broking / Insurance / Financial
Planning / other)
Description of Current Business
Years in Current Business
Years
Months
If less than 5 years, please list previous Employers/Businesses:
Previous Employer/Business 1
Position Held
Duration of Employment
Years
Months
Years
Months
Previous Employer/Business 2
Position Held
Duration of Employment
REFERENCES
Please provide details of two lender representatives (eg BDMs/Relationship Managers)
Name 1
Position
Lender
Contact No – Mobile OR Work line
Email Address
Name 2
Position
Lender
Contact No – Mobile OR Work line
Email Address
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LENDER ACCREDITATIONS
Residential Lenders
Already Accredited?
Adelaide Bank
Yes
No
AFM (Australian First Mortgage)
Yes
No
AMP Bank
Yes
No
ANZ
Yes
No
Bankwest
Yes
No
Citibank
Yes
No
Commonwealth Bank
Yes
No
Crown Lending
Yes
No
Deposit Power
Yes
No
Heritage Building Society
Yes
No
Homeloans Ltd
Yes
No
Homeside
Yes
No
ING Direct
Yes
No
Keystart (WA only)
Yes
No
La Trobe
Yes
No
Liberty
Yes
No
LoansToday
Yes
No
Macquarie
Yes
No
ME Bank
Yes
No
Paramount
Yes
No
St George
Yes
No
Suncorp
Yes
No
The Rock Building Society
Yes
No
Westpac
Yes
No
Commercial Lenders
Already Accredited?
ANZ
Yes
No
Bankwest
Yes
No
Commonwealth Bank
Yes
No
MacLease
Yes
No
Mildura
Yes
No
St George
Yes
No
Westpac
Yes
No
5
State accreditation # OR if opting out
I
State accreditation # OR if opting out
VERSION 081113
ADDITIONAL INFORMATION REQUIRED
Have you, or any associated party in your business:
Ever been declared bankrupt or been subject to any form of insolvency administration? (yes/no)
Has bankruptcy been discharged, and if so when?
Yes
✔
No
Ever been declared bankrupt or been subject to any form of insolvency administration in the last 7
years?
Yes
✔
No
Been found guilty of an offence involving fraud, dishonesty, money laundering or any other
criminal offence? (yes/no)
Yes
✔
No
In the past 10 years, been found guilty of an offence, or in the past 5 years been charged with any
offence which has not been finally determined before a court or otherwise withdrawn or
dismissed?
Yes
✔
No
Had an application for the grant or renewal of a finance broker's licence, or registration to engage
in credit/financial activities refused? (yes/no)
Yes
✔
No
Had a Lender/Originator decline, cancel or withdraw your/their accreditation or membership?
(yes/no)
Yes
✔
No
Carried out any other occupation and had your registration or permission to carry out that
occupation disqualified, canceled or suspended? (yes/no)
Yes
✔
No
Have you ever had insurance refused, canceled, declined or had any special conditions imposed?
Yes
✔
No
Had any past or pending claims made against your Professional Indemnity Insurance?
Yes
✔
No
Have you ever been banned from holding a company directorship?
Yes
✔
No
Have you had any defaults or judgments lodged against you?
Yes
✔
No
Are you subject to a pending investigation or enquiry by any government dept, ombudsman or
regulatory body?
Yes
✔
No
Have you ever been prosecuted under the Trades Practices Act, ASIC Act or Consumer Credit
Code?
Yes
✔
No
If you have answered 'Yes' to any of the above, please provided details below.
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ADDITIONAL INFORMATION (continued)
Have you or any associated party in your business/company have any other agency or referral
arrangement with the Commonwealth Bank? If so, please provide details here.
Yes
✔
No
Yes
✔
No
Yes
✔
No
Details
Have you ever been an employee of CBA, Bankwest, St Andrews Group? If yes, please
complete: Area/Dept Worked, year employment ended, reason for leaving.
Area/Dept
Until (year)
Reason for Leaving
ANZ Have you previously been accredited with ANZ Mortgage Origination? If yes, with which
company were you accredited?
Company
FRAUD POLICY
FINSURE Finance & Insurance Pty Ltd is committed to the detection and prevention of fraud in the
Mortgage Industry.
The Consequence of Fraud
Fraud is a serious criminal offence. It has the ability to cause loss and damage to the borrower, the Lender, all Member Partners
and to Finsure Finance & Insurance Pty Ltd.
Further, if convicted of fraud, you may be punished with a prison sentence. As you are no doubt aware, a lender is entitled to
cancel all payments to Finsure Finance & Insurance as a result of fraud by any one of its members. That means that the actions
of one fraudulent broker can lead to the loss of ongoing commissions for all of Finsure Finance & Insurance Members.
Accordingly, this Policy has been introduced by Finsure Finance & Insurance Pty Ltd to protect the rights of all concerned.
Fraudulent loans cannot be mortgage insured, approved or sold into the secondary market and results in unclaimable mortgage
insurance loss which, if sold must be repurchased by the lender. This loss can and will be passed on.
Finsure Finance & Insurance Pty Ltd’s Responses
All approved Originating members or Associates must be aware that they bear full responsibility for all actions of their
employees, agents and contractors and the losses that their actions may cause, and they must comply with Finsure Finance &
Insurance Pty Ltd’s policies regarding prevention of fraud.
The member is responsible for the content and quality of each application taken and submitted to any Lending Partner under the
Finsure Finance & Insurance Pty Ltd Member Agreement.
Finsure Finance & Insurance Pty Ltd will from time to time conduct a review of each member’s business to make sure they are
complying with the Loan Fraud Policy.
The Policy
Set out below is a summary of the common types of fraud, and the specific consequences that may arise. Also set out is the
specific steps that must be taken by the member to ensure that such fraud does not occur. Finsure Finance & Insurance Pty Ltd
may ask a member to provide evidence that it is complying with this policy.
Types of Fraud
Some of the common types of fraud include:
1) Submission of inaccurate information, for example:
a. False statements on loan applications
b. Falsification of documents purporting to substantiate credit, employment deposit or asset information
c. Falsification of documents as to identity
d. Falsification of evidence as to ownership/non-ownership of real property
e. Falsification of tax returns and payslips
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2)
3)
Forgery or misrepresentation of partially or predominantly accurate information
Incorrect statements regarding current residential occupancy or intent to maintain minimum continuing occupancy as states
in security instruments
4) Lack of due diligence by the Originator, including failure to obtain required by or relevant to the loan application
5) Failure to request to seek further information as may be required arising from a borrower’s response to questions
6) Submission of information or documentation, which is or should be known to be suspect or inaccurate
7) Making applications where there are two different contract prices for a property that is being purchased
8) Lodgement of simultaneous or consecutive loan applications with different lenders not disclosing that other applications
have been made
9) Making an application to different lenders for multiple owner-occupied loans from one applicant on multiple properties, or
from one applicant supplying definite information on each application, without informing the lender as to the purpose
10) Allowing an application or interested third-party to “assist” with processing of the loan
11) General non-disclosure of known and relevant information
Consequences of Fraud
Consequences to the Member:
1) Criminal prosecution with the prospect of a custodial sentence
2) Loss of Professional Practicing Certificates
3) Loss of lender accreditation due to exchange of information between lenders and mortgage insurance companies
4) Civil action by the Lender to recover losses sustained
5) Civil action by Finsure Finance & Insurance Pty Ltd to recover the losses sustained
6) Termination of the Agreement with Finsure Finance & Insurance Pty Ltd
7) Civil action by the applicant/borrower or other parties to the transaction
8) Prosecution under the Consumer Credit Code resulting in heavy fines and other penalties
Consequences to the Borrower:
1) Criminal prosecution with the prospect of a custodial sentence
2) Civil action by the lender to recover losses sustained
3) Civil action by Finsure Finance & Insurance Pty Ltd to recover losses sustained
4) Adverse effect on credit history with credit reporting agencies
5) Financial hardship due to the inability to service the loan, default under the mortgage contract or leading to foreclosure
Prevention of Fraud
The Member must:
1) Only conduct face to face interviews with prospective borrowers
2) Sight original identification documents in all cases
3) Immediately inform Finsure Finance & Insurance Pty Ltd and the Lender if at any stage they become aware that they have
been provided with is false or misleading information
4) Keep copies of all loan applications and supporting documents submitted with any loan application for a period of 2 years
5) Allow Finsure Finance & Insurance Pty Ltd to audit any loan application lodged with any lender on a reasonable notice (the
reasonable costs of such an audit to be borne by Finsure Finance & Insurance Pty Ltd)
By Signing the Declaration & Privacy Acknowledgement Section overleaf, you confirm you have read and
understood the terms and requirements of this Fraud Policy.
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DECLARATION & PRIVACY ACKNOWLEDGEMENT
Collection of Personal Information
Finsure Finance & Insurance Pty Ltd (Finsure) will collect personal information (including you full name, address and contact
details) so that your application may be assessed and your relationship with Finsure Finance & Insurance Pyt Ltd. You will be
provided with products and services, including information on Finsure’s own products and services. Where necessary,
Finsure Finance & Insurance Pty Ltd will also collect information on individuals such as company directors and officers
(where the company is a customer of Finsure’s), as well as customers’ agents and persons dealing with Finsure on a ‘one off’ basis.
You must provide us with accurate information
If you provide Finsure Finance & Insurance Pty Ltd with incomplete or inaccurate information, we may not be able to assess
your application and administer our relationship with you.
Other Disclosures
Finsure Finance & Insurance Pty Ltd may communicate personal information to organisations to which we outsource certain functions.
In all circumstances where joint venture partners, contractors and agents may become aware of personal information, confidentiality
agreements apply. Partners, contractors and agents may only use personal information for Finsure’s purposes. We may be allowed
or obliged to disclose information by law, e.g. Under Court Orders or Statutory Notices pursuant to taxation or social security laws.
Access
You may (subject to permitted exceptions) access your information by contacting Finsure on 1300 FINSURE (1300 346 787).
Your acknowledgement and consent
Your signature below indicates your consent to such use and disclosure of personal information as indicated above.
Applicant’s Declaration & Authorisation
I/We hereby declare that the information in this application is accurate and true and authorise Finsure Finance &
Insurance Pty Ltd to confirm the details in this application with third parties, as required.
Name/Director 1
Name/Director 2
Signature
Signature
Date
Date
PLEASE COMPLETE THE LIST BELOW AND PROVIDE THE FOLLOWING DOCUMENTS
100 points ID form for each broker (see next section)
Australian Credit Licence
Certificate of Company/Business Registration
COSL Membership
Current MFAA Membership Certificate
FOS Membership
MFAA Anti-Money Laundering/CTF Certificate
Current PI Certificate
MFAA Statement of Attainment
Current National Police Check
Current FBAA Membership Certificate
Current Resume
FBAA Anti-Money Laundering Certificate
Separation Letter from previous aggregator (if applicable)
Cert IV Certificate
Up-to-date VEDA Credit File
Diploma of Financial Services
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BROKER IDENTIFICATION FORM
Broker Name
Date of Birth
Residential Address
METHOD OF IDENTIFICATION:
One item from A plus another item from A, B or C below
Face to face verification by reference to an original photographic identification document. This should be supported by either
another primary photographic identification document or a secondary form of identification. Identification documentation
provided either in combination or in its own right must show the individual’s full name, date of birth, current residential address
and signature.
Please take note that a STATUTORY OF DECLARATION is required for those who are known by multiple names.
A Primary Photographic Identification:
Current Drivers Licence
Current Australian Passport (or not expired by more than 2 years)
Current Foreign Passport with acceptable Australian Residency status
Commonwealth, State or Territory officially issued Identification Card
National Identity Card
B Primary Non-Photographic Identification:
Birth Certificate
Citizenship Certificate
Pension or Health Care Card issued by Centrelink
C Secondary Identification:
Financial Benefits Statement issued by the Commonwealth, State or Territory within the last 12 months
Rates Notice issued by a local government body within the last 3 months
Utility Notice issued by a utilities provider within the last 3 months
Statement issued by a financial institution within the last 3 months
For Office Use Only:
VERIFICATION OF IDENTIFICATION
I have carried out the Face to Face verification and can confirm that any photographic documentation is a true
likeness of the individual. All documentation is current or within acceptable timeframes.
Signature
Full Name of Interviewer (FINSURE Representative)
Job Title / Position
Date
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VERSION 081113
BANK AUTHORISATION FORM – COMMISSIONS
I/We authorise FINSURE Finance & Insurance Pty Ltd to credit this account for commission payments (details provided below):
Name of Account Holder
Business Name
/
ABN/ACN
Financial Institution
Branch
Account Name
BSB
Account No
CUSTOMER ACKNOWLEDGEMENT AND DECLARATION
I/We acknowledge that this arrangement is governed by the terms of the Bank Authorisation Service Agreement (overleaf).
By signing this form, I/we declare that:
•
•
•
•
All information given to FINSURE Finance & Insurance Pty Ltd is accurate and not misleading.
I/We will not alter the credit arrangements (including closing or changing the account above) set out in this form without
notifying Finsure at least ten (10) business days prior to the next payment due date.
This executed form is agreed to be used for any/all services that will now or in the future be taken up with FINSURE Finance &
Insurance Pty Ltd or any one of its associated companies.
I/We have read the Bank Authorisation Service Agreement overleaf and understand and agree to its terms. I/We agree to be
bound by them as amended from time to time.
BEFORE SIGNING
•
•
•
If the method of operation of the nominated account requires more than one signature, then this request must be signed in the
same manner.
Do not sign this form if there is anything that you do not understand.
The person(s) signing below are all the authorised signatures/signatories to operate the account.
NOTE FOR SUB-BROKERS
Please make sure to check with your HEAD GROUP when it comes to your commissions.
YES
NO
YES
NO
Will Head Group receive ALL commission payments? If YES, DO NOT COMPLETE THIS FORM.
Will both Head Group AND Sub-Broker receive commission payments (the commission split based on the
agreement signed between Head Group AND Sub-Broker)? If YES, PLEASE COMPLETE THIS FORM WHERE
YOU WANT YOUR COMMISSION PORTION TO BE PAID TO.
Signature (Account Holder)
Name
Name
Date
Date
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VERSION 081113
BANK AUTHORISATION SERVICE AGREEMENT - COMMISSIONS
This Agreement contains the conditions of use for your commission payments. You should read these conditions of use carefully to
fully understand your rights and obligations.
1.
COMMISSION PAYMENT ARRANGEMENTS
In consideration of you entering into an Agreement with us, you agree to permit us to pay all commission earning into your nominated
account;
The form details the terms of your arrangements including, among other things, the amount, frequency, expiry (if any) and the
recipient of the funds;
You should carefully read the Bank Authorisation Form to familiarise yourself with the details of your payment arrangements.
2.
WE ADVISE YOU
This is not available on all accounts (e.g. passbook savings and credit card accounts are generally not acceptable);
To confirm the account details by checking a recent statement from your Financial Institution;
That your form must be signed in the same way as the account signing instruction held by your Financial Institution;
If you are uncertain about any of these items, please check with your Financial Institution before completing the form.
3.
YOUR ARE RESPONSIBLE FOR
Checking with your Financial Institution prior to completing the Bank Authorisation Form, that account is valid and active;
Ensuring that the authorisation on the Bank Authorisation Form is identical to the account signing instruction held by the Financial
Institution of the nominated account;
Telling us if you close or change the account you nominated; and arrange a suitable alternate payment method, if the bank account
arrangements are stopped, either by you or your Financial Institution.
4.
TIME OF PAYMENT
Commission payment may be effected at any time on the nominated day; and
Where the payment date falls on a non-business day, we will pay the amount on the next business day.
5.
ALTERATION OR CANCELLATION
You may cancel your Bank Authorisation Form, stop or request a change to the details by writing to us.
We must receive your notification at least three (3) business days prior to processing your request in time; and
If we vary any of the arrangements either set out in this agreement or Bank Authorisation Form or otherwise, we will provide you with
14 days prior written notice.
6.
DISPUTE RESOLUTION
We have a customer claims process in place with all Financial Institutions if you believe that a payment has not been correctly
processed. You should contact us first if you have a complaint regarding the amount or timing of any of our payments. We will respond
to your request within two (2) business days.
7.
PRIVACY
We will keep all information relating to your account private and confidential except to the extent that you consent to those details
being disclosed or the law requires otherwise. Your consent to us using or releasing your account information to investigate with your
and our Financial Institutions any possible incorrect debits; and we will take reasonable steps to protect personal information held by
us against loss and against access, use, modification or disclosure that is unauthorised.
8.
INDEMNITY
You indemnify us against all losses, costs, damages and liability that we suffer as a result of you breaching this agreement or you
providing us with an invalid, ineffective or non-binding Bank Authorisation details or if for any other reason the instructions contained in
the Bank Authorisation provided by you are not or cannot be performed. This indemnity includes, without limitation, legal costs and
expenses on a full indemnity basis. This indemnity is a continuing obligation, separate and independent from your other obligations
and survives termination of this agreement. It is not necessary for us to incur expense or make payment before enforcing a right of
indemnity conferred by this agreement. This indemnity does not apply as a result of our (or any of our delegates’ or agents’) fraud,
negligence or breach of trust; and you will pay us any sum due under this clause fully without reduction or set-off (and irrespective of
any counterclaim) whatsoever.
9.
GOVERNING LAW
This agreement and the transactions contemplated by this agreement are governed by the law in force in New South Wales. Each
party irrevocably and unconditionally submits to the non-exclusive jurisdiction of the courts of New South Wales and the courts of
appeal from them for determining any dispute concerning this agreement or the transactions contemplated by this agreement.
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VERSION 081113
BANK AUTHORISATION FORM – FEES
I/We authorise FINSURE Finance & Insurance Pty Ltd to debit this account for fee charges (details provided below):
Name of Account Holder
Business Name
/
ABN/ACN
Financial Institution
Branch
Account Name
BSB
Account No
CUSTOMER ACKNOWLEDGEMENT AND DECLARATION
I/We acknowledge that this arrangement is governed by the terms of the Bank Authorisation Service Agreement (overleaf).
By signing this form, I/we declare that:
•
•
•
•
All information given to FINSURE Finance & Insurance Pty Ltd is accurate and not misleading.
I/We will not alter the direct debit arrangements (including closing or changing the account above) set out in this form without
notifying you at least ten (10) business days prior to the next direct debit due date.
This executed form is agreed to be used for any/all services that will now or in the future be taken up with FINSURE Finance &
Insurance Pty Ltd or any one of its associated companies.
I/We have read the Bank Authorisation Service Agreement overleaf and understand and agree to its terms. I/We agree to be
bound by them as amended from time to time.
BEFORE SIGNING
•
•
•
If the method of operation of the nominated account requires more than one signature, then this request must be signed in the
same manner.
Do not sign this form if there is anything that you do not understand.
The person(s) signing below are all the authorised signatures/signatories to operate the account.
NOTE FOR SUB-BROKERS
Please make sure to check with your HEAD GROUP when it comes to your account fees.
YES
NO
YES
NO
Will Head Group pay ALL fees involved? If YES, DO NOT COMPLETE THIS FORM.
Will Sub-Broker pay ALL fees involved? If YES, PLEASE COMPLETE THIS FORM WHERE YOU WANT YOUR
FEES TO BE DEDUCTED FROM.
Name
Name
Date
Date
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VERSION 081113
BANK AUTHORISATION SERVICE AGREEMENT - FEES
This Agreement contains the conditions of use for your direct debit request. You should read these conditions of use carefully to
fully understand your rights and obligations.
1.
DEBIT ARRANGEMENTS
In consideration of you entering into an Agreement with us, you agree to permit us to debit service fees from your nominated account;
The Direct Debit Request details the terms of your debit arrangements including, among other things, the amount, frequency, expiry (if
any) and the recipient of the funds;
You should carefully read the Direct Debit Request to familiarise yourself with the details of your debit arrangements.
2.
WE ADVISE YOU
That direct debiting is not available on all accounts (e.g. passbook savings and credit card accounts are generally not acceptable);
To confirm the account details by checking a recent statement from your Financial Institution;
That your Direct Debit request must be signed in the same way as the account signing instruction held by your Financial Institution;
If you are uncertain about any of these items please check with your Financial Institution before completing your Direct Debit Request.
3.
YOUR ARE RESPONSIBLE FOR
Checking with your Financial Institution prior to completing the Direct Debit Request, that direct debiting is available on that account;
Ensuring that the account you nominated has sufficient cleared funds available to pay each debit as it becomes due;
Ensuring that the authorisation on the Direct Debit Request is identical to the account signing instruction held by the Financial
Institution of the nominated account;
Telling us if you close or change the account you nominated; and arrange a suitable alternate payment method, if the drawing
arrangements are stopped, either by you or your Financial Institution.
4.
TIME OF DIRECT DEBIT
Direct debits may be effected at any time on the nominated day and you must ensure that there are sufficient funds in your account to
effect the direct debit; and
Where the due date falls on a non-business day, we will debit the amount on the next business day. If you are uncertain when the
debit will be processed to your account, you should contact your Financial Institution directly.
5.
ALTERATION OR CANCELLATION
You may cancel your Direct Debit Request, stop or defer an individual debit or request a change to the debit amount by writing to us.
We must receive your notification at least three (3) business days prior to processing your request in time; and
If we vary any of the debit arrangements either set out in this agreement or Direct Debit Request form or otherwise, we will provide
you with 14 days prior written notice.
6.
DISPUTE RESOLUTION
We have a customer claims process in place with all Financial Institutions if you believe that a debit has not been correctly processed.
You should contact us first if you have a complaint regarding the amount or timing of any of our drawings. We will respond to your
request within two (2) business days.
7.
DISHONOUR FEES
It is your responsibility to ensure that you have sufficient cleared funds available in the nominated account to satisfy your direct debit
arrangements. We are under no obligation to effect a reduced direct debit; and
If a direct debit is not effected due to insufficient funds or where we choose to effect a reduced direct debit, then your account will be
adjusted and any charges incurred by us will be debited from your account.
8.
PRIVACY
We will keep all information relating to your account private and confidential except to the extent that you consent to those details
being disclosed or the law requires otherwise. Your consent to us using or releasing your account information to investigate with your
and our Financial Institutions any possible incorrect debits; and we will take reasonable steps to protect personal information held by
us against loss and against access, use, modification or disclosure that is unauthorised.
9.
INDEMNITY
You indemnify us against all losses, costs, damages and liability that we suffer as a result of you breaching this agreement or you
providing us with an invalid , ineffective or non-binding Direct Debit Request addressed to us or if for any other reason the instructions
contained in a Direct Debit Request provided by you are not or cannot be performed. This indemnity includes, without limitation, legal
costs and expenses on a full indemnity basis. This indemnity is a continuing obligation, separate and independent from your other
obligations and survives termination of this agreement. It is not necessary for us to incur expense or make payment before enforcing a
right of indemnity conferred by this agreement. This indemnity does not apply as a result of our (or any of our delegates’ or agents’)
fraud, negligence or breach of trust; and you will pay us any sum due under this clause fully without reduction or set-off (and
irrespective of any counterclaim) whatsoever.
10. GOVERNING LAW
This agreement and the transactions contemplated by this agreement are governed by the law in force in New South Wales. Each
party irrevocably and unconditionally submits to the non-exclusive jurisdiction of the courts of New South Wales and the courts of
appeal from them for determining any dispute concerning this agreement or the transactions contemplated by this agreement.
14
VERSION 081113
FINSURE BROKER BUSINESS CARDS
Do you want Finsure business cards?
 YES
 NO
If yes, please choose one of the following:
Finsure branding only:
Quantity
Finsure Brand (excluding GST)
250
$135.00
500
$145.00
1000
$160.00
Please tick:
Co-branding (Finsure plus your own brand 25 )LQVXUHSOXV1300 Home Loan):
Quantity
Finsure Co-Brand (excluding GST)
250
$185.00
500
$195.00
1000
$210.00
15
Please tick:
VERSION 081113
SYMMETRY LICENCE FORM
Broker Name
Broker Company Trading Name
Work Phone No
Work Fax No
Mobile No
Business Address
City/Suburb
State
Postcode
Postal Address (if different)
Email Address
Preferred Username
(eg johnsmith99)
Password
(must contain min 6 characters with at least 1 number and 1 letter and must be different to your username)
Administrator or Loan Writer
Branch Name (if applicable)
New (N) or Existing (E) Branch
Please email the completed form to: servicedesk@stargategroup.com.au
Credit Ombudsman Service Limited
Credit Representative Membership Application
Credit Ombudsman Service – Membership Office
T 02 9273 8455 F 02 9273 8445
M PO Box A252, Sydney South NSW 1235
E members@cosl.com.au
This form will assist us to collect information required to assess and approve an application for membership of the Credit
Ombudsman Service Limited as a Credit Representative of an Australian Credit Licence (‘ACL’) holder.
Please complete all relevant fields and ensure that persons with appropriate authority have signed and dated the Member
Agreement (see section 7).
If you require assistance or have any questions about completing this application, please call us on 02 9273 8455 between
9.00am – 5.00pm Monday to Friday (excluding public holidays) AEST.
An email will be sent within 5-7 working days of receipt advising commencement of processing. If for any the reason we
unable to process the application this email will notify any additional information we may require.
Applications generally complete processing within working 10 days. An email is sent as confirmation of membership activation
and the COSL Member number at this time. A membership kit including a Member certificate, tax invoice and other
documents will then be posted shortly after.
For more information about the Credit Ombudsman Service and to see the latest updates, please visit our website
www.cosl.com.au
Privacy Information
1. Any personal information collected, used or disclosed from time to time by the Credit Ombudsman Service Limited (COSL)
is for the purpose of enabling COSL (through its employees, contractors, agents and directors) to process an application
for membership or renewal or a change of membership details; to discharge its functions under its Constitution and Rules,
including facilitating the resolution of complaints in its capacity as an external dispute resolution (‘EDR’) scheme; and to
discharge its reporting obligations to the Australian Securities and Investments Commission (‘ASIC’).
2. COSL may publish your personal information (for example: name, COSL Member number, contact details, details of the
licensee which authorised you as a Credit Representative on the COSL website and any public list of COSL Members
(whether paper-based or electronic) maintained by COSL.
3. COSL will publish in its annual report, among other details, the number of complaints received about you. This is an ASIC
requirement.
4. COSL may disclose your personal information to others where this is permitted under its Constitution or Rules or where
this is authorised or required by law. This may include disclosing personal information to:
(a)
a relevant industry body or its disciplinary tribunal;
(b)
the COSL Board;
(c)
ASIC;
(d)
another ASIC-approved EDR scheme;
(e)
complainants who have referred a complaint to COSL;
(f)
COSL’s service providers, such as lawyers, accountants, IT consultants, printers, or mailing houses; or
(g)
any other person as may be authorised or required by law.
Application Checklist
The authorising licensee (ACL) is identified in the application and has given proper authorisation to act as a
Credit Representative.
✔
The details of the account contact, corporate nominee and complaints person contact (ACL), etc…
✔
Selected the appropriate membership category and calculated the fee payable .
✔
All relevant persons have signed the membership agreement (section 6).
✔
Included details for payment, or have attached a cheque or confirmation of payment through internet/phone
banking.
✔
Office use only
Approved: Yes __ No __
Amount $
BPAY / EFT / Chq / CC
Credit Ombudsman Service Limited ABN 59 104 961 882
Approved
Date
1
1 Details of authorising Licensee
(i.e. holder of an ACL)
1.1 Name of Licensee (ACL)
FINSURE Finance & Insurance Pty Ltd
1.2 COSL Membership Number (if applicable)
403412
1.3 Credit Representative Number (if known)
2 Applicant Details
2.1 Membership Type
Individual
>> Continue to section 2.2 if you are a sole trader or trading
under your own name.
Partnership
>> Continue to section 2.3 to add all partners on the COSL
Membership.
Company
>> Continue to section 2.4 to add company details
2.2 Individual Name
Given Names
Last Name
Given Names
Last Name
Given Names
Last Name
Given Names
Last Name
>> Continue to
section 2.5
2.3 Partner’s Names
>> Continue to
section 2.5
2.4 Company Details
Company name
Trading name
>> Continue to
section 2.5
ABN/ACN
Director’s names
2.5 Physical Address
Street
>> Continue to
section 2.6
Suburb
State/Postcode
2.6 Contact Details
Phone
Fax
Mobile
Email
>> Continue to
section 2.7
Website
2.7 Communications
Membership renewal notices and other communications from us, such as Member News, are sent via
email.
>> Continue to
section 3
If you wish to receive a printed version of the Annual Report, please tick here >>
2
3 Member Contacts
We require the following contact details to process your application.
Please complete all sections.
3.1 Accounts Contact – the person dealing with invoices, member renewals and payments…
Title
Given Names
Last Name
>> Continue to
section 3.2
Phone
Fax
Mobile
Email
3.2 Corporate Nominee – the person dealing with voting at COSL’s AGMs and other membership issues…
Title
Given Names
Last Name
>> Continue to
section 3.3
Phone
Fax
Mobile
Email
3.3 Complaints Contact Person – the person who investigates and resolves complaints…
The Licensee ACL is the complaint contact.
Although all complaints will be referred to my licensee,
I or my company nominate an additional complaint
contact.
Title
Phone
>> Continue to
section 3.5
>> Complete
details below
RUSHTON
DEAN
Mr
✔
Given Names
1300 346 787
Mobile
Last Name
Fax
Email
1800 346 787
>> Continue to
section 3.5
admin@finsure.com.au
3.5 Postal Address (if different from registered address)
Address 1
Address 2
Suburb
>> Continue to
section 4
State/Postcode
3
4 Credit Representatives
4.1
Sub-authorised
Credit
Representatives
>> Continue to
section 4.2
Yes, we have sub-authorised credit representatives who are
either employees and/or directors.
Yes, I have other sub-authorised credit representatives they
are not directors or persons employed by me or the company.
>> Continue to
section 4.3
>> Continue to
section 5
x
I have no sub-authorised credit representatives.
4.2 Your Directors and/or Employees acting as Credit
Representatives
If you are a corporate credit representative and have permission of the licensee to sub-authorise
any of the directors and/or employees to engage in credit activities, these directors and/or
employees are also credit representatives of the licensee and can be listed below. If your
employees and /or directors are directly authorised by the ACL they will require a separate
membership and should not be listed below.
Please list below the details of these sub-authorised credit representative directors and/or
employees.
Title
Given Names
Last Name
Email Address
Title
Given Names
Last Name
Email Address
Title
Given Names
Last Name
Email Address
Title
Given Names
Last Name
Email Address
Title
Given Names
Last Name
Email Address
Title
Given Names
Last Name
Email Address
Title
Given Names
Last Name
Email Address
Please attach additional sheets, if required.
Please Note:
The sub-authorised credit representatives (directors and/or employees) do not receive their own
COSL Membership Certificate (unless they are appointed as credit representatives directly by the
licensee in which case they will hold a separate COSL membership. A Schedule of Representatives
naming those sub-authorised (directors and/or employees) listed above will be provided together
with the membership certificate.
>> Continue to
section 5
4.3 Non Employed / Non Directors
If you have sub-authorised any persons other than employees or directors to engage in credit
activities, even with the consent from your licensee, each of these representatives will also need to
join an ASIC-approved EDR scheme.
To join COSL, they will each need to complete a separate Credit Representative Application Form.
>>Complete
Additional Credit
Representative
Membership
Application
Form/s
4
5 Affiliations and business categories
5.1 Please tick is a member of any of
the below :
Abacus Australian Mutuals Association of
Building Societies and Credit Unions
FAA Financiers Association of Australia
AFA Association of Financial Advisors
FBAA Finance Brokers Association of
Australia
AFSA Association of Superannuation
Funds of Australia
ACDBA Australian Debt Buyers &
Collectors Association
AIOFP Association of Independently
Owned Financial Planners
NFSF National Financial Services
Federation
AIPB Australian Institute of Professional
Brokers
MFAA Mortgage and Finance
Association of Australia
CPA Certified Practicing Accountants
Australia
FPA Financial Planning Association
Other, please state:
5.2 Business categories
Tick the boxes that apply to your business.
✔
Finance / Mortgage Broker
Collections / Repossession
Agent
Franchisee
Finance Arranger / Referrer
Financial Planner / Adviser
Investment Adviser
Insurance Broker
Mortgage Broker
Originator
Vendor Finance Broker
Commercial Lender
Credit Card Provider
Lender
Micro Lender
Motor Vehicle Finance
Personal Lending
Securitiser
Vendor Finance Provider
Complete section 6.1
>>
>>
if you have additional
Representatives
Wholesale Funder
Debt Collector / Servicer
Debt Purchaser
Franchisor
Investment Manager
Leasing / Hire / Rental
Mortgage Manager
Australian Deposit-Taking Institution
Administration Services
Network
Aggregator
Lenders Mortgage Insurer
Special Purpose Vehicle
Superannuation Services
Securitisation Trustee
Other, please state:
>>
>>
if you have additional
Representatives
5
PLEASE CHARGE FINSURE ACCOUNT
6 Payment Details – Credit Representative Applicant
Amount
Fee Applicable
6.1 Credit Representative/s
(Finance Broker; Mortgage Broker; Credit Arranger or Referrer; Repossession
Agent)
Number of representatives
X
multiplied by
$125.00
annual representative fee
=
$
$
Under $1m
$500
$
Between $1m and $5m
$700
$
Equals total annual representative fee
6.3 Current Total Portfolio size (mortgage managers, debt servicing, etc)
$
More than $5m
$____________M (Portfolio Size)*
$700+
Please enter the current portfolio size to the nearest million above. Upon
return of this completed renewal notice the membership office will calculate
the appropriate fee and issue a tax invoice for payment.
Contact us if you would like more information about this fee category.
$
$
Contact us
$
Under $1m
$600
$
Between $1m and $5m
$850
$
More than $1billion - please contact us
6.4 Current Loan Book size (credit providers and other lenders, etc)
$
More than $5m
$___________M (Book Size)*
$850+
Please enter the current loan book size to the nearest million above. Upon
return of this completed renewal notice the membership office will calculate
the appropriate fee and issue a tax invoice for payment.
Contact us if you would like more information about this fee category.
$
More than $1billion - please contact us
6.5 Other categories
6.7 Total Membership Fee
$
My total fee payable is:
$
$
Contact us
$
$
6.8 Making your payment
Mailing your payment
1.
2.
3.
Direct crediting your payment
Make your cheque payable to:
Credit Ombudsman Service Limited.
Write the name/s in which the Application is being
made on the back of the cheque.
Send the cheque, along with this Application.
Bank Name:
Account Name:
BSB:
Account:
Reference:
National Australia Bank
082-356
559629619
Please use the name/s in which the
Application is being made.
Credit Card Payment
Type of Card
MasterCard
Visa
Name on Card
Card Number
Amount of Payment
Expiry Date MM/YY
$
/
Signed
PLEASE CHARGE FINSURE ACCOUNT
6
7 Membership Agreement
I/We agree to:
1.
abide by the COSL Constitution, Rules, Guidelines and Determinations by the Ombudsman;
2.
have my contact details made available on the COSL website with reference to all representatives and
credit representatives;
3.
co-operate with COSL regarding complaints made against me, my representative or my credit
representative;
4.
advise COSL as soon as possible of any changes to my membership, contact details (including those of
a representative) or a Credit Representative;
5.
accept full and unconditional responsibility for the conduct of a representative or credit representative
authorised under my membership,
and declare that:
1.
I am not bankrupt, insolvent, under administration or an externally administered body corporate;
2.
Where I am or have been a member of the Financial Ombudsman Service (FOS):
3.
Signature
(a)
I have not been expelled or suspended from membership of FOS,
(b)
There are no outstanding fees owing to FOS,
(c)
All decisions of FOS that are binding on me have been complied with within the time required,
(d)
I am not aware of any finding by FOS of a serious misconduct or systemic issue in relation to me,
(e)
I authorise COSL to make such enquiries to FOS as it considers necessary to verify 2(b), (c) or (d),
(f)
I authorise FOS to provide COSL with any information as COSL considers necessary to verify 2(b) or
(c) above,
(g)
I authorise COSL to inform FOS whether there are any outstanding fees owing to COSL, whether
decisions of COSL that are binding on me have been complied with, and whether COSL has made a
finding of a serious misconduct or systemic issue in relation to me.
The information given in this application is complete, true and correct.
x
Date
/
/ 20
x
Date
/
/ 20
x
Date
/
/ 20
Name
Signature
Name
Signature
Name
Please take note when signing
1.
All partners to a partnership membership must sign the Membership Agreement.
2.
A company may execute a document without using a common seal if the document is signed by:
3.
(a)
two directors of the company; or
(b)
a director and a company secretary of the company; or
(c)
for a proprietary company that has a sole director who is also the sole company secretary - that director.
A company with a common seal may execute a document if the seal is fixed to the document and the fixing of the seal is
witnessed by:
(a)
two directors of the company; or
(b)
a director and a company secretary of the company; or
(c)
for a proprietary company that has a sole director who is also the sole company secretary—that director.
7
Loan Writer
Accreditation Application form
Business Relationship Manager:
Completed accreditation forms to be returned to:
Adelaide Bank Broker Support
Email: brokersupport@adelaidebank.com.au
Fax: (08) 8300 6850
LOAN WRITER DETAILS
This application seeks accreditation for:
✔
residential loans
Full name:
Business name:
Postal address:
Office address:
Email:
Phone number:
Fax number:
Mobile number:
Note: if this application is for a change to your current accreditation, please provide your agent code:
MEMBERSHIP
*Mandatory information
Provision of proof of the following information is required to process your application. Without this information your application will not
proceed.
Australian Credit Licensing Registration / Licence / Credit Representative #:
/
*Please attach a copy of the email or equivalent from ASIC confirming your license number
Aggregator/Broker group:
*Please attach a copy of your membership certificate or written confirmation from your listed Aggregator.
Industry Membership
MFAA
FBAA
I.e. MFAA, FBAA, FPA
Industry membership number:
*Please attach a copy of your certificate to confirm industry membership
ACCREDITATION PROCESS
1.
2.
3.
4.
Complete accreditation form and return to Adelaide Bank via fax or email as above.
Adelaide Bank will create an individual agent code for broker/adviser and will forward details via email.
Agent code must be used when submitting any loan applications).
If you are already accredited for residential or commercial loans, any additional accreditation will be added to your existing agent
code.
Upon receipt of agent code, or confirmation of updated accreditation, adviser/broker may begin submitting loans to Adelaide Bank.
Note: Adelaide Bank reserves the right to grant or refuse accreditation at its discretion. Accreditation is subject to periodic review and
update. This may be as a result of (but not limited to), legislative changes, product reviews, compliance requirements or loan writers no
longer representing the group to whom accreditation was achieved.
LOAN WRITER DECLARATION
I acknowledge that Adelaide Bank is relying on the truth and accuracy of the information contained in this declaration and that any error
or omission may cause Adelaide Bank to incur damage or loss and I declare the above information to be true and correct.
Please tick if you DO NOT wish to receive marketing emails.
Full name:
05/10/11
Signature:
Date:
Adelaide Bank a Division of Bendigo and Adelaide Bank Limited, ABN 11 068 049 178, 169 Pirie Street, Adelaide, SA 5000
ABL0411
AMP Bank
Originator Application for Accreditation
Please print in CAPITAL LETTERS and place a cross ✗ in any applicable boxes.
1. (All sections must be completed)
Are you applying to be accredited for:
✔
Loan products Only
Loan products and Deposit products
2. Originator details
Title
Suburb
Mr
Mrs
Miss
Ms
State
Postcode
State
Postcode
Other
First name
Residential address
Middle name
Suburb
Surname
Email address
Date of birth
D D M M Y Y Y Y
Business address
Business phone number
(
Business mobile number
)
Facsimile number
(
Years lending experience
)
3. Licensing
National Consumer Credit Protection Act 2009 (NCCP) licensing
requirements for originators. From 1 January 2011 brokers may
only engage in credit activities as defined by section 6 of the
NCCP if they:
1. are a Licensee that has been issued with an Australian Credit
Licence (ACL), or
2. have been appointed as an authorised Credit Representative
by a Licensee that has been issued with an ACL, or
3. are an employee or director of a Licensee that has been
issued with an ACL.
Please mark the box that is applicable, provide ACL/CRN details
and for option 3 only, a director of the Licensee must sign to
confirm:
1. Broker is licensed in own name
Licence number (ACL)
2. Broker is authorised as a Credit Representative
Broker’s Credit Representative Number (CRN)
3. Broker is a director or employee
I confirm that the originator above is a director/employee of
the above Licensee:
Signature of director
✗
Date
D D M M Y Y Y Y
Name of director of Licensee
Name of Licensee
384704
Issued by AMP Bank Limited ABN 15 081 596 009, Australian credit licence 234517, AFSL No. 234517.
1 of 9
4. Originator Declarations
How we may use your personal information
We use your personal information to:
You are currently a member of one of the ASIC approved
External Dispute Resolution (EDR) schemes below:
Financial Ombudsman Service (FOS)
Credit Ombudsman Service Limited (COSL)
Have you ever been declared bankrupt, or been subject to
control under the Bankruptcy Act 1966?
Yes
✔
No
If Yes - please provide details below.
Have you ever been found guilty of a criminal offence involving
fraud, dishonesty or money laundering?
Yes
✔
No
Have you ever had an application for the grant or renewal of a
finance broker’s licence, or for registration to act as a finance
broker, refused in any State or Territory in Australia?
Yes
✔
No
Have you ever had an Industry Association decline any
membership application or withdraw your/their accreditation
or membership?
Yes
✔
No
Have you ever carried on any other occupation, profession or
business that is regulated under any enactment of any State or
Territory of Australia and had your/their licence, registration or
permission to carry on that occupation, profession or business
suspended or cancelled, or you/they have been disqualified
from carrying on that occupation, profession or business?
Yes
✔ No
Enter details of any of the above here:
– assess whether to accept your Originator Application for
Accreditation form,
– administer and manage our relationship with you,
– facilitate our internal business operations, including
fulfilment of any legal requirements and confidential
systems maintenance and testing, and
– inform you in your business capacity of products and
services provided by us or any member of the AMP group
which we consider may be of value or interest to your clients
unless you tell us not to.
Our right to disclose your personal information
We may disclose your personal information if it is necessary to
do so in the following circumstances:
– to any regulatory body,
– to any credit reporting agency to obtain a commercial and/
or consumer credit report, trade reference or other
commercial and/or consumer information about you to
accept your Originator Application for Accreditation form,
– to our external service providers that provide services for
the purposes only of our business, on a confidential basis,
for example advisers and mailing houses,
– to any persons acting on your behalf, including your solicitor
or accountant, unless you tell us not to,
– to any party acquiring an interest in any business, and
– if you request us to do so or if you consent or where the law
requires or permits us to do so.
Your authority to us
By signing this Originator Application for Accreditation form
you authorise us to collect, maintain, use and disclose your
personal information in the manner set out in this privacy
statement.
5. Privacy Statement
Privacy statement
What this statement is about
Your right to privacy is important to us. This statement explains
your privacy rights and our rights and obligations in relation to
your personal information.
The Privacy Act 1988 regulates the way AMP Bank Limited
(“we”) uses personal information provided about you. Please
read the following carefully as it sets out how we may use
information about you.
You need not give us any of the personal information
requested in the Originator Application for Accreditation form
or any other document or communication relating to the
application. However, without this information, we may not be
able to enter into a Originator Manager Agreement with you.
You may seek access at any time to personal information held
by us about you and ask us to correct it if you believe it is
incorrect or out of date.
2 of 9
6. Originator application
I declare that the information provided in this Originator
Application for Accreditation form is correct. I apply to be
appointed as an Originator for AMP Bank Limited on the terms
set out in this Originator Application for Accreditation form
and AMP Bank Limited’s standard Originator Terms set out in
Annexure A to this Originator Application for Accreditation form.
I acknowledge that my appointment as an Originator is not
effective unless and until AMP Bank Limited’s acceptance of
my application is communicated to me.
8. Accreditation checklist
Prior to sending, please ensure the following items have been
checked and included (please check and tick each box).
A. New accreditation requirements
Complete and sign this Originator Application for
Accreditation form. A signature is required at section 6.
Attach a certified copy of your current Driver’s Licence or
Passport.
By completing this application I confirm that I maintain
Professional Indemnity insurance that covers me for liabilities
arising from origination of loans and/or arranging deposits, as
applicable and other business and activities covered by the
Originator Terms with a sum insured of at least $1 million.
Attach a copy of your Statement of Attainment certificate
for either Certified Credit Adviser/Credit Adviser/Associate
Credit Adviser Accredited Mortgage Consultant from the
MFAA or for either Accredited Member/Associate Member
from the FBAA.
By completing this application I confirm that I hold and will
continue to maintain status as:
Originator Manager to endorse at section 9.
a) Certified Credit Adviser/Credit Adviser/Associate Credit
Advisor/Accredited Mortgage Consultant through MFAA, or
Complete the training and accreditation test(s) with your
BDM and attach the results.
B. Transfer of accreditation requirements
b) Accredited Member/Associate Member of the FBAA, and
Complete and sign this Originator Application for
Accreditation form. A signature is required at section 6.
that I am and will continue to be a member of the ASIC approved
EDR scheme selected above in clause 3.
Complete section 7 or provide a separation letter from your
previous Originator Manager (Aggregator).
Signed
✗
Date
D D M M Y Y Y Y
9. Originator Manager (Aggregator) endorsement
Name of Originator Manager (Aggregator)
Name
7. Transfer of accreditation
Outgoing Originator Manager (Aggregator) to complete this
section only if you are transferring your accreditation from
another group, OR obtain written authorisation.
Name of outgoing Originator Manager (Aggregator)
Name
We hereby declare that the information in this application is
correct and endorse the accreditation of the originator for:
✔
Loans Only
Loans and Deposits
Signed
✗
Date
The Originator Manager (Aggregator) confirms that the
Originator is no longer affiliated with the above Originator
Manager.
Signed
✗
Date
D D M M Y Y Y Y
D D M M Y Y Y Y
Name
RACHEL RUIZ
Please send completed application and supporting documents to:
AMP Bank Support Services
Email: bank_support_services@amp.com.au
Fax:
02 8843 8381
Name
3 of 9
10. AMP Bank Use
AMP Bank acceptance
I confirm that the Originator has completed an AMP Bank training
and accreditation course.
Accepted by Business Development Officer:
Signed
✗
Date
D D M M Y Y Y Y
Name
Business support checklist
NTBS updated.
Apply Online updated.
VMS updated.
Completed by:
Signed
✗
Date
D D M M Y Y Y Y
Name
4 of 9
Annexure A - Originator Terms
AMP Bank Limited (AMP Bank) ABN 15 081 596 009, Australian credit licence 234517, AFSL No. 234517.
Level 4, Jessie Street Centre, 2-12 Macquarie Street, Parramatta NSW 2150
1. Definitions
1.1
Definitions
In this Agreement, unless the context otherwise
requires:
1. Agreement means the contract comprised of
these Originator Terms and the Originator
Application for Accreditation form;
2. ACL means an Australian Credit Licence as defined
in section 35 of the National Consumer Credit
Protection Act 2009 (Cth);
12. Customer means any person who applies to AMP
Bank for a loan, credit card or Financial Product;
13. External Dispute Resolution Scheme (EDR) means
an ASIC approved external dispute resolution
scheme;
14. Facility means an account under a Loan;
15. Financial Product has the meaning given to that
term in the Corporations Act;
16. Financial Product Advice has the meaning given to
that term in the Corporations Act;
3. AML Services means services provided in
connection with AMP Bank’s obligations under the
Anti-Money Laundering and Counter-Terrorism
Financing Act 2006 (Cth), eg the identification of
clients, as notified by AMP Bank from time to
time;
17. Financial Services has the meaning given to that
term in the Corporations Act;
4. Application means the completion of all forms
and the doing of all things by the Originator as
required by AMP Bank to enable AMP Bank to open
a deposit account; arrange for the issue of a credit
card or settle a Facility or Facility variation for a
Customer;
19. Licensee means a person:
5. ASIC means the Australian Securities and
Investments Commission;
18. GST has the meaning given to that term in the
A New Tax System (Goods and Services Tax) Act
1999 (Cth). GST also means an amount
representing GST;
a) holding an ACL;
b) who prior to the 1 January 2011 is registered to
engage in credit activities under the
Transitional Act; or
c) who prior to the Transition End Day is registered
to be licensed under the Transitional Act.
6. AUSTRAC means the Australian Transaction
Reports and Analysis Centre;
20. Loan means one or more Facilities under a Loan
Agreement;
7. Authorised Credit Representative (ACR) means a
person authorised by a Licensee pursuant to
section 64 or 65 of the National Consumer Credit
Protection Act 2009 (Cth) or a person who is an
employee or a director of the Licensee or of a
related body corporate of the Licensee;
21. Originator means the originator who has
completed the Originator Application for
Accreditation form;
8. Banking Agency Services means arranging for the
issue of a Basic Deposit Product by AMP Bank;
9. Banking Agent has the meaning given to that
term in ASIC Class Order [CO 04/909];
10. Basic Deposit Product has the meaning given to
that term in the Corporations Act 2001 (Cth);
11. Business Day means a day that is not a Saturday,
Sunday or public holiday in Sydney;
22. Originator Application for Accreditation Form
means the Originator Application for Accreditation
form provided by AMP Bank, completed by the
Originator, endorsed by the Originator Manager
and accepted by AMP Bank;
23. Originator Manager means the Originator
Manager that has endorsed the Originator
Application for Accreditation form;
24. Originator Manager Agreement means the
agreement between AMP Bank and the Originator
Manager which governs the business relationship
between AMP Bank and the Originator Manager;
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25. Party means AMP Bank or the Originator. The
Originator Manager is not a Party;
26. Regulator includes ASIC, AUSTRAC, the Australian
Prudential Regulation Authority, the Australian
Competition and Consumer Commission and the
Office of the Privacy Commissioner;
27. Related Body Corporate has the meaning given to
that term in the Corporations Act;
3.2
4. Provision of services
4.1
28. Retail Client has the meaning given to that term
in the Corporations Act;
2. AML Services; and
3. any other services which the Parties agree in
writing are to be provided by the Originator.
30. Staff means directors, partners and employees;
4.2
a) in the case of a credit card - the Customer uses
the credit card;
b) in the case of a Loan settlement of the Loan;
5. Relationship between the Parties
5.1
The relationship between the Parties is not one of
employer and employee, partners or joint venturers.
d) in the case of a Financial Product (eg a Basic
Deposit Product) - AMP Bank approves the
Application and opens the Customer’s account;
5.2
The Originator is not the agent of AMP Bank, except in
relation to the provision of the following services:
1. AML Services;
32. Taxable Supply has the meaning given to that
term in the A New Tax System (Goods and Services
Tax) Act 1999 (Cth).
2. where the Originator is authorised to provide
Banking Agency Services - Banking Agency
Services; and
33. Transitional Act means the National Consumer
Credit Protection (Transitional and Consequential
Provisions) Act 2009 (Cth); and
3. any other services which the Parties agree in
writing are to be provided by the Originator as an
agent of AMP Bank.
2. Term and termination
2.2
This Agreement commences on the date when AMP
Bank accepts the Accreditation Form and continues
indefinitely until terminated by one Party giving
written notice to the other Party.
This Agreement terminates automatically and
without notice if:
6. Training, instructions and materials
6.1
AMP Bank must provide training materials or other
training for the Originator and Staff and other
materials (eg application forms), to enable the
Originator to provide the Services.
6.2
AMP Bank retains ownership of all training materials,
written instructions and other materials (eg software)
provided.
6.3
The Originator must undergo such training and ensure
that Staff undergo such training, in the provision of
the Services to be provided pursuant to this
Agreement as AMP Bank or the Originator Manager
may from time to time require.
6.4
In performing its obligations under this Agreement
the Originator must follow and ensure Staff follow, all
instructions given by AMP Bank or the Originator
Manager to the Originator from time to time.
6.5
On termination of this Agreement the Originator
must ensure that all training materials, written
instructions and unused stocks of other materials
provided directly or indirectly by AMP Bank are
destroyed.
1. the Originator Manager Agreement is terminated;
2. the Originator Manager gives the Originator
written notice that the Originator Manager has
revoked its endorsement of the Originator; or
3. the Originator Manager notifies AMP Bank that
the Originator has ceased to be either a Licensee
or an Authorised Credit Representative.
3. Previous agreements
3.1
The appointment in clause 4.1 is not an exclusive
appointment.
c) in the case of a Facility, settlement of the
Facility; and
34. Transition End of Day has the meaning provided in
section 4 of the Transitional Act.
2.1
AMP Bank appoints the Originator to provide:
1. the Services in relation to the products specified
in the Originator Application for Accreditation
form;
29. Services means the services to be performed by
the Originator which are attached to the
Originator Application for Accreditation form;
31. Successful Application means:
However, this Agreement does not affect any accrued
rights under such previous agreements, eg any rights
of the Originator to commissions (including trail
commissions) on successful applications under
previous agreements.
This Agreement replaces any previous agreements
between the Parties to the extent that they deal with
the same subject matter.
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c) cover for compensation awards made by an
ASIC-approved External Dispute Resolution
Provider (eg Financial Ombudsman Service (FOS)
or Credit Ombudsman Services Limited (COSL));
7. Records, inspection and audit
7.1
7.2
7.3
The Originator must keep proper records of the
Services it provides pursuant to this Agreement for at
least one year after the provision of the particular
Service.
d) run-off cover for 6 years (or as otherwise agreed
between the Originator Manager and AMP Bank)
after the Originator ceases to be an Australian
Credit Licensee or a Credit Representative of an
Australian Credit Licensee;
During the term of this Agreement and for a period
of one year afterwards, AMP Bank may, on giving
10 Business Days' notice and at its expense, carry out
an inspection and audit to determine whether the
Originator has properly performed its obligations
under this Agreement.
e) the Insurer is regulated by APRA or is otherwise
exempt under the Insurance Act 1973; and
f) cover for the Insured’s:
The Originator must provide AMP Bank, its
representatives and professional advisers with
reasonable access during normal business hours to all
relevant records necessary to enable AMP Bank to
carry out the inspection and audit. The Originator
must ensure that its Staff co-operate fully with AMP
Bank, its representatives and professional advisers
and promptly provide to AMP Bank, its
representatives and professional advisers an
explanation of any matter reasonably required by
them in connection with the inspection and audit.
(i) fraud and dishonesty;
(ii) defamation;
(iii) intellectual property infringement;
(iv) loss of documents; and
The Originator must provide full and current copies of
the insurance policies as AMP Bank or the Originator
Manager from time to time may require by written
request.
8. Indemnity and insurance
9. Customer complaints and disputes
8.1
9.1
The Originator must notify AMP Bank within 24 hours
of any complaint by any Customer in relation to any
matter connected with this Agreement.
9.2
Any client complaint against the Originator as agent
of AMP Bank must be dealt with under AMP Bank’s
internal and external dispute resolution procedures. In
any other case, the Bank may require the Originator to
allow the complaint to be dealt with under AMP
Bank’s internal and external dispute resolution
procedures.
9.3
The Originator must provide AMP Bank with such
assistance as AMP Bank reasonably requires to deal
with any Customer complaint.
9.4
Where the Originator is authorised to provide Banking
Agency Services, before providing any Banking Agency
Services to a Retail Client, the Originator must
specifically draw to the Retail Client’s attention the
availability of AMP Bank’s dispute resolution system.
AMP Bank must give instructions to the Originator as
to how to do this.
The Originator must indemnify AMP Bank against:
1. all losses suffered by AMP Bank;
2. all liabilities incurred by AMP Bank; and
3. all costs actually payable by AMP Bank to its own
legal representatives (whether or not under a
costs agreement) and other expenses incurred by
AMP Bank in connection with any demand, action,
arbitration or other proceeding (including
mediation, compromise, out of court settlement
or appeal);
in connection with any breach of this Agreement by
the Originator.
8.2
During the term of this Agreement the Originator
must be covered at all times by professional
indemnity insurance that covers its liabilities arising
from its business as an Originator of Loans and other
Services covered by this Agreement and incidental
activities, with a sum insured of at least $1 million per
claim covering activity and breaches of the Originator
and its employees, contractors, sub-contractors and
agents (Insured). The professional indemnity
insurance policy must include and provide for:
a) one reinstatement of the aggregate limit;
b) cover for loss or damage suffered by consumers,
customers, clients or potential customers or
clients of the Insured, resulting from a breach by
the Insured of the National Consumer Credit
Protection Act 2009 (Cth), and breaches of relevant
legislation including but not limited to Trade
Practices Act 1974 (Cth), Corporations Act 2001
(Cth), ASIC Act 2001 (Cth), Privacy legislation;
10. Other Originator obligations
10.1 The Originator must maintain Accredited Mortgage
Consultant (AMC) status with the Mortgage and
Finance Association of Australia (MFAA) or Associate
Member or Accredited Member status with the
Finance Brokers Association of Australia (FBAA).
10.2 The Originator must:
1. be either a Licensee or an Authorised Credit
Representatives and must provide evidence to this
effect on request by AMP Bank or the Mortgage
Originator; and
7 of 9
2. comply with all its obligations as a licensee or an
Authorised Credit Representative during the terms
of this Agreement.
10.3 The Originator must notify the Originator Manager
immediately if the Originator:
1. ceases to be a Licensee or an Authorised Credit
Representative of a Licensee; or
2. changes from being the Authorised Credit
Representative of one Licensee and commences to
be the Authorised Credit Representative of
another Licensee.
10.4 In providing the Services, the Originator must exercise
the care and skill of the ordinary skilled provider of
those services.
10.5 Where the Services relate to a Loan, a Facility or credit
card, the Originator must provide AMP with all
information that comes to the Originator’s attention
that may be relevant to AMP Bank’s decision whether
to approve the application.
10.6 The Originator must not engage, and must take
reasonable steps to ensure that its Staff do not engage,
in any conduct that might harm the reputation of AMP
Bank or any of its Related Bodies Corporate.
10.7 The Originator must not amend any printed materials
provided directly or indirectly by AMP Bank or any of
its Related Bodies Corporate without AMP Bank’s
prior written consent.
10.8 The Originator must not use any logo of AMP Bank or
any of its Related Bodies Corporate without AMP
Bank’s prior written consent.
10.9 The Originator must not provide any Financial Product
Advice to any Customer.
10.10 The Originator must not provide any Services,
including any Financial Services, on behalf of or as
agent of AMP Bank except as authorised by this
Agreement.
10.11 The Originator may use its Staff to perform this
Agreement but subject to this, the Originator must
not subcontract the performance of the whole or any
part of this Agreement.
10.12 The Originator must provide AMP Bank with such
assistance as AMP Bank reasonably requires to deal
with any enquiry or intervention by any Regulator.
10.13 Other than at the initiative of the Customer, both
during the term of this Agreement and for 3 years
after its termination, the Originator must not:
1. solicit any Customer who made a Successful
Application for an AMP Bank Loan or credit card to
apply for a loan or credit card from another credit
provider to refinance all or part of any such Loan
or credit card provided by AMP Bank; or
2. solicit any Customer who made a Successful
Application for a Financial Product to:
a) close the account relating to the Financial
Product and acquire a similar product at
another financial institution; or
b) withdraw the proceeds of the account relating
to the Financial Product and deposit these
proceeds at another financial institution.
11. Compliance with applicable laws
11.1 In performing this Agreement each Party must
comply, and must ensure that its Staff comply, with
all applicable laws, licences and codes of conduct.
12. Confidentiality
12.1 The Originator must keep confidential, and ensure
that its Staff keep confidential:
1. all records of AMP Bank and its clients; and
2. all training materials and written instructions
provided directly or indirectly by AMP Bank.
13. Client relationship
13.1 Subject to this Agreement, both during the term of
this Agreement and after its termination AMP Bank
and its Related Bodies Corporate may deal, without
restriction, with any person who becomes a client of
AMP Bank as a result of Services provided by any
Originator pursuant to this Agreement.
14. No liability for software
14.1 AMP Bank excludes all liability for indirect and
consequential loss or damage of any kind (including for
loss or corruption of data, loss of revenue, loss of profits
of any kind (whether direct, indirect or otherwise), failure
to realise expected profits or savings of any kind
(whether direct, indirect or otherwise) however caused,
whether in contract, tort (including negligence), under
any statute or otherwise, arising from or related in any
way to any software provided to the Originator.
15. Variations
15.1 This Agreement may be varied by agreement in
writing between the Parties.
15.2 AMP Bank may also vary this Agreement by giving
written notice to the Originator or the Originator
Manager.
16. Restriction on assignment
16.1 This Agreement is not capable of assignment by
the Originator without the prior written consent
of AMP Bank.
8 of 9
17. Notices
18. Severability
17.1 A notice or other communication connected with
this Agreement (Notice) has no legal effect unless
it is in writing.
18.1 If any provision in this Agreement is unenforceable,
illegal or void or makes this Agreement or any part of
it unenforceable, illegal or void, then that provision is
severed and the rest of this Agreement remains in
force.
17.2 In addition to any other method of service provided
by law, the Notice may be:
1. sent by email to the email address; or
2. sent by prepaid post or delivered to the ordinary
address;
of the addressee specified in these Originator terms
or on the Accreditation Form, or as subsequently
notified to the other Party.
19. Governing law and jurisdiction
19.1 This Agreement is governed by the law in force in New
South Wales.
19.2 The Parties submit to the non-exclusive jurisdiction of
the courts of New South Wales and the
Commonwealth of Australia.
17.3 If the Notice is sent or delivered in a manner provided
by clause 17.2, it must be treated as given to and
received by the Party to which it is addressed:
1. If sent by email before 5pm on a Business Day at
the place of receipt - on the day it is sent and
otherwise on the next Business Day at the place of
receipt;
2. if sent by post - on the 2nd Business Day (at the
address to which it is posted) after posting; or
NS4759 01/12
3. if otherwise delivered before 5pm on a Business
Day at the place of delivery, upon delivery, and
otherwise on the next Business Day at the place of
delivery.
9 of 9
MORTGAGE ORIGINATOR
TRANSFER REQUEST
Return Fax No.: 1300 558 219
Name:
Business
Address:
Telephone:
Facsimile:
Mobile:
Email:
The following information is required specifically for identify authentication purposes and website registration.
The ‘ID Question’ should be something that only you would know the answer to, eg: mother’s maiden name. It
will be asked to confirm identity, please ensure you complete your D.OB, both ID Question’ and ‘ID Answer’.
D.O.B:
ID Question:
What is your mother's maiden name?
ID Question Answer:
PREVIOUS ACCREDITATION DETAILS:
Previous AO/SAO Number:
Previous Originator Company:
Reason for leaving:
TRANSFER REQUEST DETAILS:
Company you are transferring to:
NCCP LICENSING DETAILS: (please select one of the following)
I have my own licence:
( must provide registration/licence number)
I will be a credit representative
(must provide registration/licence number)
I will be an employee of the company: Please see attached paperwork (if applicable)
Which ASIC approved External Dispute Resolution Scheme are you a
member of? Eg COSL
COSL
FOS
x Written confirmation from the Originator Company I am transferring to is attached to

this application form which also confirms that I am a member of either MFAA or FBAA
and that I hold EDRS membership. This also confirms my licence registration details as
above (signed letter on company letterhead).
Please note: Transfer requests cannot be processed until written confirmation is received
along with a Letter of Separation from your previous Aggregator advising you have left
under no adverse reasons.
If you are unable to produce such documents your transfer may take longer to process.
BROKER DECLARATION:
I confirm that the above details are true and correct. I understand that ANZ may contact
my previous Originator Company, and may decline my transfer request at it's discretion.
Signature:
Date:
Please note that any applications submitted under your previous Originator
Company cannot be transferred to your new company.
ACCREDITATION APPLICATION FORM
Please ensure all details below are true and correct.
The individual seeking accreditation and the authorised company representative must complete all fields.
The authorised company rep is required to email the completed form to ANZ at origtraining@anz.com.
DATE:
To be completed by individual applying for accreditation:
Title:
Name:
DOB:
Company Name:
Business Reference 1:
Business Address (including State, Suburb and
Postcode - physical address MUST BE PROVIDED):
Mailing Address
Postcode):
(including
State,
Suburb
and
Business Reference 2:
Phone Number:
Fax Number:
Previous Employers - Last five years (If ANZ,
please provide salary number):
Mobile Number:
yrs
E-mail Address:
yrs
Have you previously been accredited with ANZ
Mortgage Origination?
Yes
✔
No
Have you ever been refused accreditation by a
lender?
Yes
No
Have you been dismissed from an originator
company?
Yes
Have you ever been declared a bankrupt?
Yes
Do you have a criminal record relating to an offence
of dishonesty, fraud or similar offence?
Yes
✔
✔
✔
✔
If Yes, with which company were you accredited?
Own Licence, Aggregator Credit Representative or
Employee:
Please provide Registration/Licence number or
Credit Representative Number:
Own
No
No
No
Credit Rep
ACL
Employee
Rep#
To be completed by Authorised Company Representative:
Approved Originator Company:
Authorised Company Representative name:
RACHEL RUIZ
Have you satisfactorily confirmed the identity of
the above applicant?
YES
Have you completed a Police check on the above
applicant?
YES
Was the Police check satisfactory?
YES
Which Industry body is the Applicant a member
of? i.e: MFAA or FBAA
MFAA
FBAA
Which ASIC approved External Dispute Resolution
Scheme is the applicant a member of? (COSL)
COSL
FOS
Have you completed a Reference check on the above
applicant?
YES
Was the Reference check satisfactory?
YES
Please confirm that the above individual has their own
licence, is a Credit Representative or an employee of
your Originator Company.
The Registration/Licence number/Credit Representative
number quoted above is correct?
Own
Credit Rep
Employee
YES
This form is to be used by Australia and New Zealand Banking Group Limited (ABN 11 005 357 522) to assess whether an applicant is suitable for
training and accreditation as an Approved Officer in accordance with the Originator Agreement. This information will only be used and disclosed within
the ANZ Group of companies. An individual referred to on this form may access this information by contacting ANZ.
Bankwest, a division of Commonwealth Bank of Australia
ABN 48 123 123 124
AFSL / Australian credit licence 234945
Broker Sales
Bankwest Broker New Accreditation & Transfer of Accreditation Application Form
Please email all documentation including this application, which must be typed and completed in full to your Aggregator for their approval. Your
Aggregator will then forward to Bankwest for processing.
Date:
Surname:
First Name:
Middle name:
Aggregation Group:
Your Employer or your Company name:
Business Street Address:
State & Post Code:
Phone Number: (including Area Code)
Mobile Number:
Fax Number: (Including Area code)
Email address:
Full Accreditation
Transfer
State to State Transfer & Reinstatement
All Questions
1-5, 8-10
10
1. Have you ever been an employee of the Bankwest / St Andrews, and or CBA Group?
Please state area / department, year of employment and reason for leaving.
Yes
✔
No
Continue to Question 2.
Area / Department worked
Year employment ended
Reason for leaving
2. Have you attached a legible and current copy of Primary Photo ID?
Yes
✔
Failure to provide will result in a delay in processing and return of application to your Aggregator.
No
3. MFAA or FBAA membership information
MFAA / FBAA membership number:
MFAA / FBAA expiry date:
4. Have you attached your current MFAA or FBAA membership Certificate? (Not certificate of Attainment)
MFAA
FBAA
Yes
No
5. Are you currently or have you previously been Accredited with Bankwest?
Yes
Previous Bankwest ID:
Attach a copy of release from your former Aggregator advising that you left under no adverse terms.
No
Continue to the Question 6.
Broker Accreditation Application 15102012
1
ABN 48 123 123 124
Broker Sales
6. Have you attended a Bankwest Accreditation training session?
Yes
Input details below and continue to question 7.
No
You will need to attend a training session. Please contact your Partnership Manager to arrange an appointment
Address of training?
Date of training:
7. Have you attached a current Police Check which is less than 12 months old?
Yes
✔
No
8. Have you attached a copy of your current resume (showing Employer, Role/Responsibilities and length of service covering last 10 years)
Yes
✔
Continue to Question 9 (required for Transfers if previous accreditation was held for under 2 years)
Continue to Question 10
No
9. Does your resume show two years lending experience?
Yes
No
yrs
Complete the below:
Mentor / Supervisor Name and Position:
Name:
Position:
And provide one of the following:
MFAA mentor approved application
Mentor resume confirming minimum 2 years’ experience as a loan writer
Letter or email from Aggregator (this does not include Sub-Aggregator or third parties) to confirm that Mentor is a direct employee to
the Aggregator
OR
Mentor / Supervisor Name and Bankwest Broker ID (if held for more than 2 years):
Name:
Broker ID:
2
ABN 48 123 123 124
Broker Sales
NCCP Licensing Requirements
10. Complete options a (Credit Rep) or b (Director or Employee) as below
a). Representative is an Authorised Credit Representative; (if in Business name a Business Extract is required)
Authorised Credit Representative Number:
Entity's Licence Number:
384704
Licensed Entity's Name:
Finsure Finance & Insurance Pty Ltd
OR
b). Representative is a Director or Employee of a licensed Entity; (If Director, provide copy of ACL; if Employee, provide letter from Licence
holder confirming employment and Copy of ACL)
Director / Employee (circle one)
Entity's Licence Number:
Licensed Entity's Name:
Personal Identifier
The following information is required specifically for identity authentication purposes (i.e. To confirm caller identity prior to releasing
confidential information).
You must take reasonable measures to keep the nominated identifier confidential.
Identifying Question:
What is your Mother's Maiden Name?
Identifying Answer:
I understand that this application for accreditation will be assessed by Bankwest and that accreditation approval is at the discretion of
the Bank. The Bank will notify me of the outcome within 10 working days upon receipt of all of the required documentation and
successful completion of Bankwest's accreditation training.
Signature of Broker
3
ABN 48 123 123 124
Broker Sales
Privacy Statement
This Statement explains how Bankwest, a division of Commonwealth Bank of Australia ABN 48 123 123 124 AFSL / Australian credit licence 234945,
collects, uses and discloses personal information and provides your consent for us to assess your application for accreditation as a broker. Personal
information is information about, and which identifies, an individual, including information about credit worthiness, standing, history and capacity.
Purposes for which we collect and use personal information
You agree that personal information about you provided to us at any time in regard to broker accreditation may be held and used by us
to assess and process the application, establish, provide and administer the accreditation including any ongoing assessment or
renewal of the accreditation, execute your instructions and, as relevant, comply with legislative/regulatory requirements, investigate
fraudulent activity, perform administrative tasks including systems development, testing, credit scoring and training, manage our
rights/obligations regarding external payment systems, conduct market/customer satisfaction research, systems, conduct market/customer
satisfaction research, develop and administer arrangements (e.g. rewards programs) with organisations for the promotion, administration
and use of our and their products/services, develop and identify products/services that may interest you, and tell you about them (unless
you ask us not to). You also consent to our collection of sensitive personal information (e.g. about health, religion or criminal record).
Disclosure of personal information
You agree we may disclose personal information about you, as appropriate, to our related bodies corporate, assignees, agents,
contractors and external advisers, organisations for verifying your identity, your agents, advisers, referees, executor, administrator, trustee,
guardian or attorney, law enforcement, regulatory and government bodies, anyone who introduces you to us, entities for reporting or
ascertaining whether you have engaged in any fraudulent activity, your franchisor, payment systems operators, your and our insurers or
prospective insurers and their underwriters, any person we consider necessary to execute your instructions, and other organisations with
whom we have arrangements (including our related bodies corporate) and their agents for the supply and (unless you tell us not to)
marketing of our respective products and services. You also agree to such disclosure to an organisation overseas which is not subject to
privacy obligations equivalent to those applying to us.
Access to your personal information, contacting us and contacting you
You may access information we hold about you at any time in accordance with the Privacy Act 1988. Unless you ask us, by calling
13 17 18, not to contact you about products and services and not to disclose your information to others for that purpose, you consent
to us contacting you by telephone while you hold any facility with us notwithstanding registration at any time of your telephone number
on the Do Not Call Register.
Name of Broker
Signature of Broker
Date Signed
Head Group Approval and Declaration by Authorised officer
I confirm that the above mentioned applicant is associated with (name of Aggregator that has Broker Agreement with Bankwest) .
I will inform Bankwest immediately if the above mentioned individual is no longer associated with (name of Aggregator that has Broker
Agreement with Bankwest) so that the allocated Broker ID may be deactivated.
Aggregator Name
Aggregator's Staff Member Name
RACHEL RUIZ
Aggregator's Staff Member Position
SALES SUPPORT MANAGER
Signature
Date
4
Application For Registration Master Introducer Details
Introducer Name:____________________________________________________________
Previous involvement with any Introducer that should now be cancelled?
Introducer ID
 Yes  No
If yes, previous Introducer Name/Number_________________________________________
Representative ID
Note: Citibank allows brokers to have only one active accreditation at any given time – any previous
accreditation will now be cancelled
Australian Credit Licence (ACL) Details
 Individual Licence
 Credit Representative
 Director/Employee*(strike out non-applicable)
ACL Registered Name: ____________________________________________________ ACL Number: _______________________
If ACL details are blank, applicant is a Credit Rep of Finsure (ACL no. 384704). Applicant's Credit Rep no. is
Representative Details
Ms/Mrs/Mr
______________________________________________________________________________________________________
Business/Trading Name__________________________________________________________________________________________
Address: _________________________________________________________________________________________________________
State__________________
________________________________________________________
Postcode_________________
Home Address: __________________________________________________________________________________________________
State__________________
__________________________________________________________
Business Phone: (____)_______________________________
Fax: (____)_______________________________
Postcode_______________
Home Phone: (____)_________________________________
Mobile:___________________________________________________________
Driver’s Licence No: ______________________________
Mother’s Maiden Name: __________________________________
Email:____________________________________________________________________________________________________________
Website:_________________________________________________________________________________________________________
Preferred Contact Method to receive information:
✔

Email
 Fax
 SMS
 Post
 Do not send
I confirm that the information set out above is true and correct
Signature of Representative ____________________________________________
Date:__________________
Office Use Only (to be completed by Facilitator)
 Attended Citibank Broker Training
 Copy of AML/CTF Training Certificate and Certificate IV in Financial Services attached (mandatory)
 Training Program completed for Mortgages covering product, process and policy (mandatory)
I confirm that training has been completed as per Policy Requirements
Name/Signature of Facilitator: _______________________________________________ Date________________
Name of the BDM for Representative:_____________________________________________________________
Citigroup Pty Limited ABN 88 004 325 080 AFSL 238098 Page 1 of 2 Mortgages – Broker Accreditation (Mar 2011) Application For Registration IMPORTANT INFORMATION You should retain this Notice PRIVACY NOTICE The Privacy Act regulates the way we use personal information about you. National Privacy Principle 1.3 requires us to make you aware of the following: 1.
Access rights You are entitled under the Privacy Act to access the information an organisation holds about you. You may contact Citibank, 2 Park St, Sydney NSW 2000 to access your personal information as follows: Citibank Privacy Officer Citigroup Pty Limited 2 Park Street Sydney NSW 2000 Tel: Email: 2.
13 24 84 privacy.officer@citibank.com.au Purposes of collection Citibank will only collect personal information necessary for the service. The information Citibank collects from you on the application for registration, and which Citibank acquires from you or other people during the course of administering the appointment, is required to process your application and to administer the appointment. 3.
Organisations to whom information may be disclosed Citibank may disclose your information on a confidential basis for the purposes set out below: To: Citigroup Pty Limited and other financial institutions Credit reporting agencies and other bureaus Mailhouses and related service providers Other organisations wishing to acquire an interest in any part of Citibank’s business 4.
For: Commission payments and administration of the arrangements relating to the appointment Credit checks and verification of details Provision of information and news relating to the appointment Assessment of any proposed acquisition Main consequences of not providing the information. If Citibank is unable to collect all the information requested in the application process, it may be unable to process the application or administer the appointment. Your Authority to Citibank You agree that information about you may be used as described in this Privacy statement. Where you have provided information about any other individual in your application, you will make that individual aware of the provisions of this Privacy statement. Citigroup Pty Limited ABN 88 004 325 080 AFSL 238098 Page 2 of 2 Mortgages – Broker Accreditation (Mar 2011) ACCREDITATION application
INTRODUCER / AGGREGATOR DETAILS
Introducer / Aggregator Name
CORPORATE STRUCTURE
ACCREDITATION TYPE
 Company
 Sole Trader
PROPOSED BRANCH / FRANCHISE NAME
Legal Entity Name (if trust involved, record “Trustee Name ATF the Trust Name”)
Trading Name (if different)
ACN (if trust involved, record ACN of the Trustee)
ABN (if trust involved, record ABN of the Trustee)
Credit Rep Number
Name and Number of ACL holder
384704
Business Street Address
Business Mailing Address
PRINCIPAL / LOAN WRITER PERSONAL DETAILS
INDIVIDUAL PRINCIPAL’S FULL NAME & DATE OF BIRTH (SEPARATE FOR PER INDIVIDUAL PRINCIPAL)
 Mr
 Ms
 Mrs
 Miss
 Other:
Surname
First Name
Middle Name/s
Date of Birth
CURRENT RESIDENTIAL ADDRESS (NO PO BOX)
Residential Address
Suburb
State
Postcode
CONTACT DETAILS
Phone
Mobile
Fax
Email
ENDORSEMENTS
RACHEL RUIZ
Signature (Introducer / Aggregator Endorsement by Authorised Officer)
Name in print
Date
Signature (Submitted by Principal / Loan Writer)
Name in print
Date
AUSTRALIAN CREDIT LICENCE 384704
PAGE 1 OF 3
14 february 2013 (v13.2)
ACCREDITATION application
PRIVACY STATEMENT CONCERNING YOUR PERSONAL INFORMATION (PRIVACY ACT 1988)
RESIMAC Limited ACN 002 997 935 (“RESIMAC”) understands that your privacy is important. We are committed to ensuring that your personal
information is handled properly by our staff and our service providers. We comply with the Privacy Act 1988 as amended by the Privacy (Private Sector)
Amendment Act 2000 (“Act”).
This Statement is to make you aware of matters required to be disclosed by the National Privacy Pinciples (NPPs) in relation to personal information
(such as your name and address and contact details) (“Personal Information”) that has been provided to us in relation to an application made by you for
accreditation as a mortgage origination under the RESIMAC mortgage securitisation programme.
This Personal Information will be handled by RESIMAC in accordance with the National Privacy Principles and this statement.
NOTE: The use of credit reports and information derived from those reports is regulated by Part IIIA of the Act. You should have separately received
details of how this information will be handled. If you have not, please contact us.
Collecting and Using Personal Information
RESIMAC only collects and uses Personal Information that is necessary for its business purposes with you. In particular, we will use your Personal
Information:
a.assess your application to mortgage originator to RESIMAC;
b.verify your details;
c.assess our risk for legislative purposes;
d.process and manage your application; and/or
e.administer the business relationship with you.
If you do not provide the Personal Information required, RESIMAC may not be able to provide you with its products and services. In addition we may use
your Personal Information to provide you with information about our existing and new products and services.
Disclosing Personal Information
In order to provide our products and services, we may need to share Personal Information with other organisations. Commonly, organisations we would
share such information with, include:
• related companies
• agents, contractors and service providers to RESIMAC
• your referees
• rating agencies
• mortgage insurers
• title insurers
• funders
• your or our professional advisers
• financial institutions
• other credit providers
• government and other regulatory bodies
• law enforcement agencies
• debt collectors
• trustee companies
Further request for and verification of Personal Information
In order to comply with its obligations under the Anti-Money Laundering and Counter Terrorism Financing Act 2006 (“AML/CTF Act”), RESIMAC may
request further Personal Information from you, even if such information was previously obtained.
The Personal Information may be used for assessment and verification for compliance under the AML/CTF Act. You consent to the use of the Personal
Information for such purposes.
You also consent to the disclosure of your personal information to a third party who provides services in respect of verification of identification for AML/
CTF purposes.
If you do not provide the Personal Information required, RESIMAC may not be able to provide you with credit or other products and services.
When RESIMAC requests Personal Information from you for this purpose, you must comply with such requests.
Accessing and Updating Personal Information
You may access your personal information by contacting your usual contact person at RESIMAC or RESIMAC’s Privacy Officer on the contact details
below.
Our Contact Details
RESIMAC Limited
Level 9, 45 Clarence Street Sydney NSW 2000
Telephone: 1300 764 447 • Facsimile: 1300 732 226
PAGE 2 OF 3
14 february 2013 (v13.2)
ACCREDITATION application
ACKKNOWLEDGEMENT AND AUTHORITY TO GIVE AND RECEIVE PERSONAL INFORMATION (PRIVACY ACT 1988)
Search Agent
RESIMAC Limited (“RESIMAC”) ACN 002 997 935
I acknowledge that I have made an application to RESIMAC Limited ACN 002 997 935 for accreditation under its securitisation programme.
I agree that RESIMAC can obtain a Veda Advantage Credit Report on all parties named in this authority.
RESIMAC can disclose any report of personal information about me to another person in connection with or the exercise of their rights in respect
of management, credit enhancement, warehouse facilities, funding, financial accommodation or otherwise by means of an arrangement involving
securitisation.
Signature
Name in Print
Date
NEW LOAN WRITER (INTERNAL USE ONLY)
TRAINING BY FINLOAN BDM
 Yes
 No
Training Form Completed
Date Completed
Finloan BDM Name
APPROVAL AND SYSTEM SETUP
Approval
Date
Print Name
Signature
CRM Completion
MTS Completion
RUS Completion
LOS Completion
ID Allocation
PAGE 3 OF 3
14 february 2013 (v13.2)
Broker Accreditation Form
NB: **PLEASE PRINT IN BLOCK LETTERS**
Personal Details
Mr/Mrs/Miss/Ms__________ Last Name_________________________________________________________________________________
First name_____________________________________________________________________Date of Birth___________________________
384704
Aggregator Details____________________________________________________________________________________________________
Business trading name_________________________________________________________________________________________________
Other trading name___________________________________________________________________________________________________
Address line 1________________________________________________________________________________________________________
Address line 2________________________________________________________________________________________________________
Suburb________________________________________________________________ State___________________ P/Code_______________
Office phone___________________________Mobile__________________________________Fax___________________________________
E-mail_______________________________________________________________________________________________________________
ASIC Registration Details (Please provide copy of registration/Licence)
ASIC Registration
(Please tick appropriate option)
 Individual is a Director/Employee of an NCCP Registered Entity
 Individual is NCCP Registered (note this does not apply where a company is the registered entity-refer above)
 Individual has been appointed as a Credit Representative of an NCCP Registered Entity
Name of Registered Entity______________________________________________________________________________________________
72 068 153 926
ABN of Registered Entity_______________________________________________________________________________________________
MARCH 2000
Credit Registration Number_______________________________________________________ Date of Registration____________________
Industry Membership
Please provide a copy of your current MFAA or FBAA Certificate of Membership
N.B. If the Certificate of Membership is in a company name, please provide your Statement of Attainment as well.
I certify the above information is true and correct. Broker to sign and date.
Signature______________________________________________________________________ Date__________________________________
Heritage BDM to complete
I certify that the broker named above was referred by_________________________________________________________ (Broker Group),
and that I have provided appropriate product training.
Print Name __________________________________________________________________________________________________________
Signature______________________________________________________________________ Date__________________________________
Office
use only
Data entered:
Welcome email sent:
Staff member sign off:
This form is to be used by Heritage Bank Limited (ABN 32 087 652 924 AFSL 240984 Australian Credit Licence 240984) to assess whether an applicant is suitable for training and
accreditation as a referrer/delegate in accordance with the Referral Agreement. This information will be used and disclosed within Heritage. An individual referred to on this form
may access the information by contacting Heritage Bank on (07) 4694 9000.
Heritage Broker Accreditation Form. Heritage Bank Limited. ABN 32 087 652 024. AFSL and Australian Credit Licence 240984. Effective 03/13
DMS 1303058C
Page 1 of 1
Broker Transfer Request Form
NB: **PLEASE PRINT IN BLOCK LETTERS**
Personal Details
Mr/Mrs/Miss/Ms__________ Last Name_________________________________________________________________________________
First name_____________________________________________________________________Date of Birth___________________________
Business trading name_________________________________________________________________________________________________
Address line 1________________________________________________________________________________________________________
Address line 2________________________________________________________________________________________________________
Suburb________________________________________________________________ State___________________ P/Code_______________
Office phone___________________________Mobile__________________________________Fax___________________________________
E-mail_______________________________________________________________________________________________________________
Previous Accreditation Details
Previous Heritage Broker I.D. Number____________________________________________________________________________________
Previous Originator Company___________________________________________________________________________________________
Reason for leaving____________________________________________________________________________________________________
Transfer Request Details
384704
Company you are transferring to________________________________________________________________________________________
NCCP Licencing Details
(please select one of the following)
 I have my own licence: (must provide registration/licence number)________________________________________________________
 I will be a credit representative (must provide registration/licence number)_________________________________________________
COSL
FOS
✔ Which ASIC approved External Dispute Resolution Scheme are you a member of? Eg COSL____________________________________

✔ Written confirmation from the Originator Company I am transferring from is attached to this application form (a signed Letter of

Separation on company letterhead).
✔ A copy of my current MFAA or FBAA Certificate of Membership.

N.B. If the Certificate of Membership is in a company name, please provide your Statement of Attainment as well.
✔

A copy of my licence registration details as above is attached as well.
Please note: Transfer requests cannot be processed until written confirmation is received along with a Letter of Separation from your
previous Aggregator advising you have left under no adverse reasons. If you are unable to produce such documents your transfer will
not be processed.
I certify the above information is true and correct.
Signature______________________________________________________________________ Date__________________________________
Office
use only
Data entered:
Staff member sign off:
This form is to be used by Heritage Bank Limited (ABN 32 087 652 924 AFSL 240984 Australian Credit Licence 240984) to assess whether an applicant is suitable for training and
accreditation as a referrer/delegate in accordance with the Referral Agreement. This information will be used and disclosed within Heritage. An individual referred to on this form
may access the information by contacting Heritage Bank on (07) 4694 9000.
Heritage Broker Transfer Request Form. Heritage Bank Limited. ABN 32 087 652 024. AFSL and Australian Credit Licence 240984. Effective 03/13
DMS 1303058A
Page 1 of 1
Broker Checklist
New Accreditation
Loan Writer Accreditation Checklist
(complete all except 8 & 13b)
Change of Aggregator
(complete all except 13a & 14)
1.
Loan Writer’s name:
2.
Business name:
3.
Street address:
4. Mailing address:
5.
Email address:
6. Contact details
Business phone:
Mobile:
Fax:
Other:
7. Aggregation group: FINSURE Finance & Insurance Pty Ltd
8. Previous Aggregation group:
(where Loan Writer is changing Aggregator group)
9.
Loan Writer’s MFAA or FBAA full membership number:
10. Loan Writer’s AML/ CTF student number:
See attached AML Certificate
11a. Loan Writer’s NCCP Registration/ License number*:
OR
11b. i. Loan Writer’s NCCP Credit Representative number*:
ii. Name and ACL number of Licensee that appointed Loan Writer as Credit Representative:
Finance & Insurance Pty Ltd
Name: FINSURE
ACL:
384704
12. Loan Writer’s COSL, FOS number (or other ADR body):
13a. Date of Homeloans accreditation training (i.e. on-site or by telephone):
OR
13b. Effective date of change of Aggregator:
14. Has the Loan Writer accreditation been completed face to face? (please circle)
If not, please provide brief details why in the ‘comments’ section below
Yes/ No
15. Homeloans BDM comments/ recommendation:
16. Homeloans BDM’s name:
17. Signed:
Date:
Date:
18. Reviewed by (print name):
19. Signed: *Complete only one, depending on NCCP status. Homeloans Limited. ABN 55 095 034 003. AFSL 247829. ACL 247829
May 2011
New Representative
Accreditation Form
To be faxed/e-mailed to Homeside prior to attendance by the proposed consultant to Homeside’s Induction Training. All sections are mandatory and must be completed.
Date:
Broker Group (NAB contract holder):
Representative/Individuals Name:
Company Name (as registered with ASIC):
Trading Name (if different to Registered name) Postal Address:
State
Postcode
State
Postcode
Street Address (if different to postal address):
Phone Number:
Mobile Number:
Fax Number:
Email Address:
NCCP licensing requirements for representatives
From 1 January 2011 representatives may only engage in credit activities if they:
1. have applied for, or been issued with an Australian Credit Licence (ACL);
2. have been appointed as an Authorised Credit Representative (ACR) by an entity that has applied for or been issued with an ACL; or
3. are an employee or director of an entity that has applied for or been issued with an ACL.
Please tick the box that is applicable and provide details. Please indicate “Applied for” in the appropriate section if you have applied for an Australian Credit Licence (ACL) or Authorised Credit Representative (ACR) of a licence applicant or current licence holder.
Representative is licensed in own name;
1.
Licence Number:
2.
Representative is an Authorised Credit Representative;
Authorised Credit Representative Number: Entity’s Licence Number (Please provide Entity’s licence
number with ACR number):
384704
Representative is a Director or Employee of a licensed Entity;
3.
Entity’s Licence Number:
Page  of 2
Homeside Lending is a division of National Australia Bank Limited (‘NAB’) ABN 12 004 044 937 AFSL 230686
NCCP registration and licensing requirements for representatives (continued)
A current Certificate of one of the below qualifications is required for accreditations from 1 July 2009 (a copy is required).
• F
NS40804 – Certificate IV Financial Services (Finance/Mortgage Broking)
Yes
No
NS50504 – Diploma of Financial Services (Finance/Mortgage Broking Management)
• F
Yes
No
The following must be supplied to enable accreditation of a loan writer or Broker Representative:
•
•
•
•
a
national criminal history record check of not more than three months old*+:
identification as per the customer identification requirements detailed in the NAB Broker guide:
e
vidence of membership to an external dispute resolution (can be under employer’s name)*:
a credit report*: and
Evidence of completion of training in the following subjects:
•
•
•
•
•
•
AML/CTF*#+
National Consumer Credit Protection Act*# (NCCP)
Privacy Act*#
Trade Practices*#
Code of Banking Practice*#
Secret Commissions*#
*Evidence of MFAA membership is sufficient to
satisfy these requirements.
+ FBAA membership satisfies this requirement.
#Certificate IV in Financial Services (Finance/Mortgage Broking)
satisfies this requirement.
Have you ever had accreditation declined or cancelled by Homeside, National Australia Bank Limited or another Lender:
Yes
✔
If ‘Yes’ provide details:
Recent Employment History (two years minimum):
1.
Broker/Director of own mortgage broking business for
years
2.
• I consent to receiving commercial electronic communications from Homeside Lending including updates on loan approvals
via Homeside’s “Loan Alert” system.
• I also consent to receiving electronic communications from Homeside of a marketing or promotional nature, including
important information about Homeside Lending products and policies.
Proposed Representative/Individual Signature:
✗
Date:
Broker Group Representative Signature:
✗
Date:
Broker Group Representative Name (please print):
RACHEL RUIZ
Broker Group Representative Position (please print):
BANK USE ONLY
Approved by (Senior Relationship Manager & Code): ✗
Date:
Signed off by (State Manager/Head of Partnership Programs):
✗
Corporate Use Only:
Broker/Franchisee Code:
Date: Entered by:
Welcome E-mail sent
Checked by:
Brokernet updated
Page  of 2
Date:
No
Existing Representative
Amendment Form
Please fax completed form to commissions 1300 724 355. All fields must be completed.
Action
✔
Direct Transfer of Accreditation (Section1).
Re-activation
of a non-active broker (Section2). Authorisation to re-activate this broker is granted. Research indicates that
the de-activation was not due to any fraudulent or inappropriate action by the broker.
Change of Contact Details (Section1).
SRM/RM Transfer (Section 2). ACL details required for Aggregator transfers and reactivations only.
Deactivation (Section 1).
Section 1: Broker Contact Details
Broker Name:
(AGGREGATOR: Finsure Finance & Insurance Pty Ltd)
Representative/Individuals Name:
Representative/Individual SPID:
Please tick the applicable box to indicate your Australian Credit Licence ( ACL). See over-page for explanatory notes.
1. Licensed Representative (in own name):
ACL No.
2. Authorised Credit Representative of a licensed entity (Please provide Entity’s ACL Number with ACR number):
Representative’s Authorised Credit Representative Number:
Entity’s ACL No.
384704
3. Employee or director of a licensed entity:
Entity’s ACL No:
Address details:
State
Loan Alert Email Address:
Postcode
Loan Alert Mobile Number:
Date Change Effective:
For Transfer or Re-activation purposes does Loanwriter hold a current Certificate of one of the below qualifications (copy of Certificate is required)
• FNS40804 – Certificate IV Financial Services (Finance/Mortgage Broking)
• FNS50504 – Diploma of Financial Services (Finance/Mortgage Broking Management)
Page  of 2
Yes
Yes
No
No
Section 2: panel transfer Details
Please note: We can only transfer SRM/RM retroactively to the first date in the current commission run.
Transfer From/To
From: SRM/RM: To: SRM/RM Signature (Required for SRM/RM transfers):
Current Sales Budget assigned to Broker: $ Rationale For Transfer:
State Manager Name: State Manager Signature:
Purpose of Transfer (Transfer invalid if not completed): Target For New SRM/RM:
* Please note this is an internal document only.
Last updated 21 May 2010
corporate office USE ONLY
Code:
Date: Entered by:
Checked by:
Brokernet updated
NOTES
National Consumer Cedit Protection Act 2009
Licensing requirements for representatives.
From 1 January 2011 individual representatives may only engage in ‘credit activities’ if they:
1. have applied for, or been issued with an Australian Credit Licence (ACL);
2. have been appointed as an Authorised Credit Representative (ACR) by an entity that has applied for or been issued with an ACL; or
3. are an employee or director of an entity that has applied for or been issued with an ACL
In Section 1 of the form you must indicate your current licensing status. Please indicate “Applied for” in the appropriate section if
you have applied for an Australian Credit Licence (ACL) or Authorised Credit Representative (ACR) of a licence applicant or current
licence holder.
Page  of 2
ING DIRECT Broker Accreditation Form
Upon completion, the Broker Accreditation form is to be submitted for processing to accreditations@ingdirect.com.au. Accreditations will be processed
within approximately 48 hours of receipt.
New Accreditation
Transfer
Broker Personal Details
Title
First Name
Surname
Date of Birth
/
Yes
No
/
Contact Details
Business Name
Business Address
Unit/Shop Number
Street Number
Street Name
Suburb
StatePostcode
Business Phone Number
Fax Number
Mobile
Email Address
Compliance Details
Australian Credit Licence (ACL) Details
ACL status: Registered
✔
Applied
Licensed
Name of ACL holder Licence Number
384704
Relationship to ACL holder (e.g. Employee, Authorised Credit Representative or Individual licence holder)
Own
Credit Rep
Employee
To help us verify your identity when you contact us, please provide the following:
Secret Question (e.g. What is your mother’s maiden name?)
What is your mother's maiden name?
Answer
Industry Body Membership
Are you currently a Mortgage Finance Association of Australia or Finance Brokers Association of Australia member?
✔
AML / CTF Course (Training provider):
See attached certificate
Student Number
Completion Date
New Brokers to the Industry
New Brokers (<2 years) to the industry must have an approved mentor in place. Please provide details of your current mentor:
Name of Mentor
Mentor’s Introducer Number
Previous Accreditation Details:
Previous Broker ID Number Previous Aggregator Name
Reason for leaving:
Page 1 of 3
ING DIRECT is a division of ING Bank (Australia) Limited | ABN 24 000 893 292 |
INGD IM369 04/12
Broker Business Information
Current portfolio size
Total estimated annual settlements across all lenders
$
Percentage of business activity spent on mortgage broking
%
Please select other products sold:
Commercial Mortgages
Insurance
Personal / Business
Deposit Products
Leasing
Personal loans
Superannuation
Other – please specify
Broker Declaration
Have you or any of your associates ever declared bankruptcy?
Yes
✔ No
Have you or any of your associates ever been found guilty of an offence involving fraud, dishonesty, drug trafficking or money laundering?
Yes
✔
No
If ‘Yes’, please explain:
Has your accreditation ever been refused or revoked with any other lender?
Yes
✔
No
If ‘Yes’, please explain:
I have completed this form and declare the information I have provided to be true and correct.
I understand that as an ING DIRECT Accredited broker I will be granted access to the introducer website. I have read, understood and agree to the website
Terms and Conditions outlined in this form.
The representations have been made to ING DIRECT to enable it to determine whether or not to accredit me as a broker. I understand and acknowledge
that ING DIRECT is relying on the information in this form to determine whether to offer accreditation.
Name
Signed by Broker
Date
/
/
Aggregator Accreditation Verification
I have reviewed and retained the following items:
✔
A police check has been completed and was satisfactory
✔
Evidence that AML / CTF training has been completed and is recognised by the FPA, MFAA, FBAA, Austrac or other training institutes endorsed by
ING DIRECT
✔
✔
Evidence the broker is a National Credit Code Authorised Person
Evidence that the broker’s identification has been verified using a Driver’s licence or equivalent document. This confirms the information provided by
broker meets the AML / CTF requirements.
the
Aggregator Declaration
I hereby formally declare that to the best of my knowledge, all information provided is complete, true and correct. I can confirm that all documents listed
above have been checked thoroughly and meet the requirements as specified in the ING DIRECT Introducer Agreement.
Name
RACHEL RUIZ
Position
Signature
Date
/
/
Page 2 of 3
INGD IM369 04/12
Terms and Conditions of use
When you log in to the ING Bank (Australia) Limited ABN 24 000 893 292 (“ING DIRECT”) website for Introducers, http://introducer.ingdirect.com.au
hereinafter referred to as “the site”, you are agreeing to be bound by the following terms and conditions of use. Please ensure you understand them
before you use this site.
1.User acknowledgment - You guarantee and warrant that you are authorised by the Introducer organisation you work for to bind that organisation
to these terms and conditions of use as though references to “you” include references to your organisation (unless the context requires otherwise).
2.Security – To maintain security you must keep your 6-digit access code and broker number confidential and never store them together. You must
not keep your Access Code or Broker Number in any form, whether encoded or unencoded, in a location where it is capable of being copied or
used by any person other than you. Your Access Code should be changed on a regular basis to maintain confidentiality. Access to the site will
be given on the correct entry of a Broker Number and Access Code. Once access is granted, any action by that person will be taken to be made
with the authority of the customer and ING DIRECT may carry out that request. You must immediately notify ING DIRECT if you know that your
Access Code has been compromised or become known to a third party, or if you know of any unauthorised use of your Access Code. In these
circumstances, you must immediately change your Access Code.
3.Indemnity – You agree to indemnify ING DIRECT and all other users of the site against any claim, loss, cost, damage, action or expense which ING
DIRECT or any other user may experience arising from your use of the site, your failure to keep your Access Code confidential, the use of this site
by any person on your behalf or the use of your Access Code by any other person, including any use not approved or contemplated by you.
4.No warranty - Except where expressly stated otherwise, ING DIRECT makes no warranties or guarantees in relation to the site. All terms implied
by law, except those that cannot be lawfully excluded, are excluded. ING DIRECT does not represent or guarantee that the site will be free from
errors or viruses. ING DIRECT does not represent or guarantee that access to the site will be uninterrupted. You acknowledge that the site may be
affected by outages, faults, or delays. Such outages, faults, or delays may be caused by factors, including without limitation, technical difficulties
with the performance or operation of ING DIRECT’s or another person’s software, equipment or systems, traffic or technical difficulties with the
Internet or infrastructure failures.
5.Liability of ING DIRECT – ING DIRECT will take reasonable commercial steps to ensure the information provided by the site is accurate and current.
To the extent permitted by law, ING DIRECT will not be liable for any loss, damage, liability, claim or expense whatsoever, whether in contract, tort
including negligence, statute or otherwise, arising out of or referable to use of the site, including out of:
• any omission, error or inaccuracy in information provided on the site;
• any unauthorised access to information on the site (including your customer details); or
• the unavailability of the site or the failure to perform in whole or in part, any function on the site.
Where any term or condition imposing liability is implied through the operation of any law, and that term or condition cannot be excluded, ING
DIRECT’s liability under that term or condition will be limited (in ING DIRECT’s discretion) to the resupply of the services or facilities provided, or the
cost of having such services or facilities resupplied.
6.Changes to the site – ING DIRECT reserves the right to change, remove or add to the information provided on the site and to limit access or cease
providing information on the site.
7.
Change of Conditions – ING DIRECT reserves the right to change the terms and conditions of use of the site without prior written notification.
8.Denial of Access – ING DIRECT reserves its discretion to withdraw, suspend, terminate or deny access to the site and/or particular customer details
at any time without prior notice to you, and in addition, may cancel your Access Code, including where:
• you fail to keep your Access Code and Broker Number secure;
• you use the site in contravention of the law;
• you act fraudulently, or ING DIRECT reasonably considers that your conduct could be fraudulent;
• you breach these terms and conditions of use; or
• in our opinion, there are concerns regarding security or unauthorised access.
The withdrawal, suspension, termination or denial of the site does not affect the conditions in these terms and conditions of use including relating
to your obligations to indemnify ING DIRECT and limitations on ING DIRECT’s liability.
9.Internet Access – While ING DIRECT has put in place certain security systems on its Internet site, it is unable to guarantee in all circumstances that
the site or the information contained on the site will not be subject to unauthorised access. To the extent permitted by law, ING DIRECT will not be
liable for any loss, damage, claims, expenses arising from unauthorised access to the site or the information (including customer records) retained
on the site.
10.Availability of site - You are responsible for ensuring that you have alternate contingency plans in place to enable you to conduct your business or
transaction by other means should the site be unavailable.
11.Links - The site may contain links to websites operated by third parties. ING DIRECT does not sponsor, endorse, or approve of the operators of
linked websites, or any material that may be found at linked websites. Subject to any applicable law that cannot be excluded, ING DIRECT makes
no warranties or representations regarding the content of linked websites or any products or services available through linked websites. You must
not establish any link to the site without express written permission of ING DIRECT.
12.
ING DIRECT reserves the right to call for evidence of Anti Money Laundering & Counter-Terrorism Financing accreditation at any time.
* Copyright and trademarks - Copyright in material comprising the site is owned or licensed by ING DIRECT unless indicated otherwise. All rights
are reserved.
Page 3 of 3
INGD IM369 04/12
PO Box 805
Samford QLD 4520
Fax: 07 3624 0722
INDIVIDUAL ACCREDITATION APPLICATION Broker details Title: ______ First Name: _____________________ Last Name: ________________________________
Email: _______________________________________________________________________________
D.O.B.: _____ / _____ / _____
Ph mobile: ______________________________________
Ph work: _______________________________
Ph fax: ______________________________________
Business details I am employed by / contracted to / neither /other: ________________________________
[circle most appropriate]
Business: ____________________________________________________________________________
Position Held: _________________________________________________________________________
Street Address: ________________________________________________________________________
Suburb/City: _______________________________ State: ______________
Postcode: ___________
Mailing Address: ______________________________________________________________________
Suburb/City: _______________________________ State: _______________ Postcode: ___________
Website: _____________________________________________________________________________
Do you belong to an aggregator of franchise group? Please list who:
____________________________________________________________________________________
Loanstoday Pty Ltd
pg. 1
www.loanstoday.com.au
PO Box 805
Samford QLD 4520
Fax: 07 3624 0722
INDIVIDUAL ACCREDITATION APPLICATION ASIC licensing details What is the relationship with the legal entity that you submit finance under:
I hold my own Australian Credit License.
ACL#: _______________________
OR
I am an Australian Credit Representative.
ACR#: _______________________
My ACR is issued under the following
384704
ACL#: _______________________
Note: All ACL’s and ACR’s will be verified with ASIC before accreditation is granted.
Memberships COSL
FOS
______________
( COSL or FOS)
________________________
membership #
____ / ____ / ________
expiry date
MFAA
FBAA
______________
( MFAA or FBAA)
________________________
membership #
____ / ____ / ________
expiry date
______________
(P.I. Insurance Issuer)
________________________
policy #
____ / ____ / ________
expiry date
Declaration I declare the information provided above is true and correct:
______________________________
( signature)
Loanstoday Pty Ltd
_____________________
(print name)
pg. 2
____ / ____ / ________
(today’s date)
www.loanstoday.com.au
Broker Accreditation Application
For any enquiries please contact us by Email: brokeroperations@mebank.com.au
Broker Accreditation Steps
Step 1
Step 2
Step 3
Complete Section 1 and take to the ME Bank Broker Accreditation Session
Attend the ME Bank Accreditation Session
ME Bank will confirm your accreditation by issuing you with a Broker Identification Number
Section 1
Broker details
Full name
Date of birth
D D M M
Office Number Email Address
Mobile Number
Y
Y
Y
Y Fax Number
Postal Address
State
Postcode
Licensing/Registration Details - Please select from the 3 options and provide details.
1.
2.
I am a Credit Representative (CR) of a holder of an Australian Credit Licence (ACL).
I have been issued with an (ACL);
ACL Registered Name:
FINSURE Finance & Insurance Pty Ltd ACL Number:
384704
ACL Registered Name
CR Name:
CR number:
ACL Number:
My company has also been appointed as a Credit Representative (CR) of the above ACL holder.
Company Name:
3.
CR number:
I am an employee/director of a holder of an ACL.
ACL Registered Name
ACL Number:
Broker Business Details
Business/Company name
Phone Number
Business Fax Number
Business/Company address (if different from postal address)
State
Postcode
Broker Declaration
1.
2.
3.
4.
I declare that I have never been bankrupt or made arrangements with creditors under bankruptcy legislation.
I declare that I am responsible to promptly inform ME Bank if there are any changes to my status as a credit licensee or as a Director/Employee or as a credit representative of a credit licensee.
I acknowledge that the approval of my accreditation is subject to my attendance of an ME Bank Broker Accreditation Session.
I understand and acknowledge that the law requires applicants to provide true and correct information and state all the names by which they are commonly known. I also understand that the
law prohibits the use of false names, as well as the giving, use or production of false or misleading information of documents in connection with an identification procedure.
5. I consent to receive any notice or other communication relating to my accreditation with ME Bank at the email address I nominate in this application (or at another address that I subsequently nominate to the
bank) and agree that an electronic communication to that address will constitute notice in writing for the purposes of this agreement. I also consent to electronically receive information, including updates on loan
approvals and marketing information, about ME Bank's products and services.
6. I acknowledge that if ME Bank terminates my accreditation on the grounds that I am suspected to have acted dishonestly or fraudulently, ME Bank may report full details of the reasons for the termination,
including copies of relevant documents, “after the fact of termination”, to an “Approved Industry Association” and I will not hold the bank liable for reporting that fact.
7. I declare I have obtained passes for National Consumer Credit Code, Privacy Act and Anti-Money Laundering/Counter Terrorism Financing Act Accreditation from an approved registered
training organisation.
8. I declare that I am a member of MFAA/FBAA and have current Professional Indemnity Insurance.
9. I understand that my accreditation with ME Bank begins on the day that I receive my Broker Identification Number.
10. I agree to supply ME Bank with any information ME Bank may request from time to time in order to confirm that I meet accreditation requirements.
11. I agree that ME Bank is collecting my personal information in order to assess my application for accreditation and if my application is approved, to administer my appointment.
12. I acknowledge that my personal information may be used and disclosed to third party service providers for these purposes and that without this information, ME Bank may not be able to consider or process my
application for accreditation.
Broker name Broker signature
Members Equity Bank Pty Ltd ABN 56 070 887 679 BC0002e/3/0912/211695
Date
D
D
M
M
Y
Y
1
Section 2
Aggregator Declaration
1. I recommend that ME Bank Accredit
to act as our nominee in accordance with our intermediary arrangments.
2. I confirm that the information provided in section 1 of this application is true and correct
3. I agree to supply ME Bank with any information ME Bank may request from time to time in order to confirm that the broker meets accreditation requirements outlined by ME Bank.
4. I confirm that the Broker:
• has current Professional Indemnity Insurance;
• is a member of an ASIC approved external dispute resolution scheme;
• has satisfactorily completed Police, Credit and Reference checks, and
• is a current member of MFAA/FBAA.
5. I acknowledge that FINSURE Finance & Insurance Pty Ltd
is responsible:
(Insert name of aggregator)
• for the Brokers conduct, remuneration, currency of licensing status, Professional Indemnity Insurance, external dispute resolution scheme; and
• to promptly inform ME Bank if there is any change to the Broker licensing/registration status.
Authorised Officer Name Signature
Date
RACHEL RUIZ
D
D
M
M
Y
Y
D
M
M
Y
Y
D
M
M
Y
Y
ME Bank use only
To be completed by a Business Development Manager or delegated Accreditation Officer of ME Bank
Please tick to verify completion:
Application complete
Broker Declaration signed
I declare that
Name has attended the ME Bank Broker information session.
(Insert Broker name)
Signature
Date
D
To be completed by ME Bank Broker Operations
Aggregation Group confirmed
Aggregator Declaration signed
ASIC search completed to verify ACL/CR Number
Broker Identification number generated
Email sent to broker and aggregator with ME Bank broker number and welcome pack
Broker Data base updated
Name Signature
Date
Members Equity Bank Pty Ltd ABN 56 070 887 679 BC0002e/3/0912/211695
D
2
Suite 25, Elevation Building
6 Meridian Place,
Bella Vista NSW 2153
PO Box 6139 Baulkham Hills BC 1755
REQUEST FOR ACCREDITATION
Mortgages
Leasing
_______________________________________________________________________________________________
Aggregator :........................................................................................................................
Broker Details
Australian Credit Registration/Australian Credit Licence Number:..…………………………
Or Australian Credit Registration /Credit Representative Number: ………………………..
Broker Name:……………………………………………………………………………………..
Company Name:………………………………………………………………………………….
Postal Address:…………………………………………………………………………………...
Trading Address:………………………………………………………………………………….
Land Line: …………………………………………………………………………………………
Mobile:……………………………………………………………………………………………..
Fax:…………………………………………………………………………………………………
Email:………………………………………………………………………………………………
I confirm that the above broker is a current member of:
“…………………………………………………”
aggregation services.
I also confirm that we hold on file current copies of (please tick each held on file):
MFAA
FBAA
MFAA /FBAA Membership
✔ AML Certificate/ Course Completion.
✔
Clean
Police Check.
✔ Business Registration
✔ Professional Indemnity Cover.
✔ Australian Credit Registration
/ Australian Credit Licence Number
.
Signed on behalf of “……………………………….”
Aggregation
Position:………………………………………………………………………..
RACHEL RUIZ
Name:………………………………………………………………………….
Signature:……………………………………………………………………..
Please email back to reception@paramountmortgages.com.au
Paramount representative:………………………………………………….
Signature:………………………………
DATED:…………………
ATOMS Transfer Form for Mortgage Brokers
This form is to be completed when a Mortgage Broker is Moving from one Aggregator Company to Another
Broker Full Name
Licensing Details
STG Broker ID:
Registration Number/Licence Number or CRN
Date of Birth
Drivers License Number
State:
Existing Broker Company and Code
Code:
Email Address
Phone
Street Address
Suburb
State
Postcode
New Aggregator Company Details
384704
Do you have any Loans in the system at present?
Form is to be emailed to atoms@stgeorge.com.au
All transfers require a signed letter from your outgoing Aggregator Company confirming they are
approving this request.
Retail and Small Business
Please complete accreditation application details required then send your accreditation application, with
required attachments as per accreditation checklist, to either of the following:
Email
bc.accreditation@suncorp.com.au
Facsimile
1300 884 912
Signature must be provided with application
Once completed application requirements have been forwarded to either of the above, you should receive
confirmation within two (2) business days.
Should you have any questions regarding accreditation application, please contact the Suncorp Mortgage Tracking
Centre 1300 726 499.
Aggregator / Broker Group
Trading Name
If applicable
Broker:
ABN
Broker:
Title
Mr
Mrs
Miss
Surname
Ms ✔ Other (please specify)
,
Given Names
Date of Birth
Business Address
Please include Suburb, State &
Postcode
Postal Address
(Leave blank if same as above)
Please include Suburb, State &
Postcode
Business Phone
Business Facsimile
Mobile
Business Email
By providing your email address
you consent to us contacting you
via email
ACL Registration/Licence
Holder?
Have you at any time been
expelled from an aggregator or
industry body?
Yes - ACL Registration/Licence Name: ………………………………………
ACL Registration/Licence Number: …………………………………..
No - Are you a credit representative of a Registered/Licensed
entity?
FINSURE
If Yes, ACL Registration/Licence name of entity: ………………………….
384704
ACL Registration/Licence number of entity: ……………………………………..
No
Yes
✔ No
If Yes, please provide details
1 of 5
BROKER ACCREDITATIONAPPLICATION VERSION SEPTEMBER 2010
SUNCORP’S PRIVACY STATEMENT
Suncorp Metway Limited is a member of the
Suncorp Group.
The Privacy Act 1988 (Cth) requires us to inform
you that:
Purpose of collection
Personal information is information about an
identifiable individual and includes facts or an
opinion about you which identifies you or by
which your identity can be reasonably
determined. The collection of your personal
information is essential to enable us to conduct
our business of offering and providing you with
our range of financial products and services.
We collect personal information for the
purposes of:
•
identifying and protecting you when you
do business with us;
•
establishing your requirements and
providing the appropriate product or service;
•
setting up, administering and managing
our products and services;
•
assessing and investigating, and if
accepted, managing a claim made by you under
one or more of our products; and
•
training and developing our staff and
representatives
We may be required by law to collect your
personal information. These include, but are not
limited to, anti-money laundering and taxation
laws.
Consequences if personal information is not
provided
If we request personal information about you
and you do not provide it, we may not be able to
provide you with the financial product or service
that you request, or provide you with the full
range of services we offer.
Disclosure
We use and disclose your personal information
for the purposes we collected it.
We may also use and disclose your personal
information for a secondary purpose that is
related to the purpose for which we collected it.
2 of 5
This would happen in cases where you would
reasonably expect us to use or disclose your
personal information for that secondary
purpose.
When necessary and in connection with
purposes of collection, we may disclose your
personal information to and/or collect your
personal information from:
•
other companies within the Suncorp
group;
•
where required or authorised under our
relationship with our joint venture companies;
•
information
technology
providers,
including hardware and software vendors and
consultants such as programmers;
•
research and development service
providers;
•
your advisers, agents or representatives
•
our advisers, agents or representatives
•
if required or authorised to do so,
regulatory bodies and government agencies;
•
financial advisers;
•
lenders’ mortgage insurers and valuers
•
credit reporting agencies
•
legal and other professional advisers
•
printers and mail house service
providers
•
manufacturers
for
plastic
card
production (e.g. debit and credit cards)
In the case of sensitive information, any
secondary purpose, use or disclosure will be
directly related to the purpose of collection.
Disclosure overseas
There are also instances where we may have to
send your personal information overseas or
collect personal information from overseas.
These instances include:
•
sending your personal information to
companies in the Suncorp group;
•
when you have asked us to do so;
•
when we are authorised or required by
law to do so;
•
when we have outsourced a business
activity or function to an overseas service
BROKER ACCREDITATIONAPPLICATION VERSION SEPTEMBER 2010
provider with whom we have a contractual
arrangement;
•
certain electronic transactions; or
•
when it is necessary in order to facilitate
a transaction on your behalf.
We will only send your personal information
overseas or collect personal information about
you from overseas for the purposes in this
statement.
Access
You can request access to the personal
information we hold about you by contacting us.
In some circumstances, we are able to deny your
request for access to personal information. If we
deny your request for access, we will tell you
why.
If accessing your personal information will take
an extended period of time, we will inform you
of the likely delay. For more detailed requests
for access to personal information, for example,
access to information held in archives, a fee may
be charged to cover the associated cost of
retrieval and supplying this information.
Marketing
We would like to use and disclose your personal
information to keep you up to date with the
range of products and services available from
Suncorp. Generally, our companies in the
Suncorp group will use and disclose your
personal information for Suncorp’s marketing
purposes. We may also use your personal
information for the purpose of marketing other
products and services of third parties we think
may be of interest to you.
If you do not want us to use and disclose your
personal information for the purpose of
marketing products and services to you, you
should contact us and tell us.
Contact
Please contact us to:
•
change your mind at any time about
receiving marketing material;
•
request access to the personal
information we hold about you; or
•
obtain more information about our
privacy practices by asking for a copy of our
Privacy Policy;
You can contact us by calling 13 11 55 or
contacting us at suncorpbank.com.au or by
visiting any of our branches.
Our Privacy Policy can also be found on our
website at suncorpbank.com.au.
I confirm that all of the information that I have supplied is true and correct.
Name
:
Signature
:
Date
:
/
/
3 of 5
BROKER ACCREDITATION APPLICATION VERSION SEPTEMBER 2010
Broker Accreditation Checklist
MFAA Contact Details
FBAA Contact Details
Phone
Web
Phone
Web
:
:
1300 556 902
www.mfaa.com.au
: (07) 3252 0120
: www.fbaa.com.au
REQUIREMENTS – Suncorp Bank requires Brokers who are being accredited or
switching Aggregators to have either of the following:
 Australian Credit Registration/Licence – individual (Australian Credit Registration/Licence
confirmation is to be supplied)
Or
 Credit Representative – for brokers choosing to be represented under the Credit Licence of
another entity (Copy of Credit Representative appointment letter to be supplied)
In addition to National Consumer Credit Protection licensing obligations, Suncorp Bank requires Brokers
who are being accredited or switching Aggregators to have either of the following industry memberships:
 MFAA Accredited Mortgage Consultant (AMC)
 FBAA Accredited Member (AM) with Compliance Basics Certificate or Certificate of Attainment
New Suncorp Accreditations
MFAA
Completed Suncorp Retail and Small Business Broker Accreditation Application
Copy of CURRENT MFAA Accredited Mortgage Consultant Certificate
 Expiry date must be current and clearly displayed
or
Confirmation email from the MFAA confirming AMC status if certificate has not been received
Copy of certificate must be sent to Suncorp once received
FBAA
Copy of FBAA Compliance Basics Certificate or Certificate of Attainment
and
Copy of CURRENT FBAA Individual Accredited Member Certificate
or
Confirmation email from the FBAA confirming AM status if certificate has not been received
 Copy of certificate must be sent to Suncorp once received
Transfer of Existing Suncorp Accreditations
and
Copy of CURRENT MFAA Accredited Mortgage Consultant Certificate
or FBAA Individual Accredited Member Certificate
Copy of a severance letter/email from previous aggregator
4 of 5
BROKER ACCREDITATIONCHECKLIST VERSION SEPTEMBER 2010
Broker Accreditation Checklist
Aggregator Information – To be completed by aggregator
Authorised Aggregator
representative name
RACHEL RUIZ
Has identification for the
applicant been satisfactorily
confirmed?
✔
Yes
No
Has a police check on the
applicant been completed?
✔
Yes
No
✔
Yes
No
If No, why?
MFAA
FBAA
Other
Was the police check
satisfactory?
Which industry body is the
applicant a member of?
RACHEL RUIZ
Aggregator representative: …………………………………………………
Signature: …………………………………………… Date: …………………….
5 of 5
BROKER ACCREDITATIONCHECKLIST VERSION SEPTEMBER 2010
ACCREDITATION REQUIREMENTS
Step 1:
Complete Section 1 and supply to your aggregator.
Step 2:
Aggregator to complete section 2 and forward to The Rock by Fax on (07) 4922 8019,
accompanied by current certificates for P.I. Cover; Dispute Facility Membership; Industry Body
Membership and AML/CTF Course Completion.
Section 1
Individual Broker Name:
Approved Aggregator:
Trading Address:
Mailing Address:
Office Phone No:
Mobile Phone No:
Fax No:
E-Mail address:
Have you previously been accredited with The Rock?
Yes
No
If Yes, with which company were you accredited?
Have you ever been refused accreditation by a lender?
Yes
Have you dismissed from an Aggregator?
Yes
Have you ever been declared bankrupt?
Do you have a criminal record related to an offence of
dishonesty, fraud or similar offence?
Yes
Yes
✔
✔
✔
✔
No
No
No
No
Section 2
Aggregators Authorised Representative name and title:
Have you satisfactorily confirmed the identity of the
above applicant?
Have you been provided with a satisfactory Police check
on the above applicant?
Have you been provided with a current Professional
Indemnity Policy.
Which industry body is the applicant a member of? i.e.
MFAA or FBAA
Which ASIC approved External Dispute Resolution
Scheme is the applicant of member of? (COSL)
Evidence of your licensing status is required as follows:
 Status (Employee/Director, Licensee, Credit Rep)
 Entity to which the above status relates
 License or Registration number of this Entity
 If appointment post 30 June 2010 supply the
ASIC ACR number
RACHEL RUIZ
✔
Yes
✔
Yes
✔
Yes
Expiry date:
/
/
MFAA
FBAA
Expiry date:
COSL
FOS
Expiry date: See attached
/
/ certificate
/
Director/Employee of ACL holder. ACL#
Individual ACL holder
Credit Rep of Finsure Finance & Insurance Ltd (ACL# 384704
with Credit Rep #
I declare that the above information is true and correct.
Signature_____________________________
(Authorised Representative of Aggregator)
Version 1.6
/
1 July 2010
)
Westpac Financial Services Partnerships – ID Request/Introducer Net Form
Individual Introducer (Mortgage Broker)
Instructions: This form will allow you to request an Introducer ID and access to the Introducer Net web site.
Individual Introducer (Mortgage Broker) to complete Sections 1, 2 and 3 in full.
Aggregator/Broker Group to complete Section 4.
Incomplete forms or requests not containing all relevant signoffs cannot be accepted.
NSW & ACT
VIC & TAS
NT & QLD
WA & SA
On completion please e-mail to:
nswaccreditation@westpac.com.au
victasaccreditations@westpac.com.au
qldaccreditation@westpac.com.au
wasaaccreditations@westpac.com.au
Do you have an existing Westpac ID number
Section 1
Mr / Mrs / Ms
Yes
No
If yes, please supply
I
Introducer Details (Please print)
Given Name / Middle Name
Surname
Date of Birth
/
/
Residential Address (No PO Boxes)
State
Office Number
(
Mobile Number
)
(
Fax Number
)
(
)
Mother’s Maiden Name (For security purposes)
Email Address
Section 2
Postcode
Company Details (Please print)
Name of entity that has Broker Agreement with Westpac
Your Company Name (if different to above)
Nature of Business (ie. accountant, financial planner)
Your Company Address (where you operate from)
State
Postcode
CREDIT LICENCE / REPRESENTATIVE CONFIRMATION
Please select one of the following
Are you a credit licence holder?
Are you an authorised credit representative?
Are you a director / employee of a licence holder?
Please Provide Your Credit Licence / Representative Number
Section 3
1.
2.
Introducer Acknowledgements (Please print)
I enclose my police clearance certificate and evidence of MFAA/FBAA membership.
I acknowledge and agree that Westpac Banking Corporation (or its related entities) may use personal information I have provided
in this form for the purpose of administering my business relationship with Westpac and to send me additional information from
time to time concerning products or services of Westpac or any of its related entities (‘additional information’). To do this,
Westpac may disclose my personal information to its related entities and service providers (such as mail houses and data
processors). (If you no longer wish to receive additional information or to enquire about any rights you may have to access to personal
information Westpac may hold about you, please contact your Business Development Manager).
I acknowledge and agree that:
• Once I am accredited as an Introducer, Westpac may allow me to access Introducer Net, provided I comply with the following
‘Conditions of Use’.
• I am responsible for all usage of the Logon ID and Password allocated to me to enable me access Introducer Net. I will not allow
another person to use my Logon ID and Password and I will not use any Logon ID or Password assigned to another user to
access Introducer Net.
• I will change any password(s) issued to me immediately upon receipt and I will keep my password secret at all times.
• My Introducer Net access may be suspended if I do not access the site for more than 90 days in a row.
• My authorisation to access Introducer Net may be restricted or revoked by Westpac at any time, and will be revoked
immediately if my business relationship with the above mentioned company ceases. Any attempt by me to access Introducer
Net after my authorisation has been revoked may constitute a breach of the Privacy Act and result in legal action.
• I may show a customer the information presented within the Application Progress and associated pages on Introducer Net with
respect to that customer’s loan application, but I must not allow a customer to have online access to Introducer Net.
• I must not divulge information relating to a customer to any other person unless that person is a joint applicant with that
customer for the same product or I am otherwise required by law to make such disclosure.
• Westpac will not be liable for any loss or damage incurred by any user of Introducer Net as a result of the interpretation or
misuse of information accessible through, or availability or non-availability of services provided on, Introducer Net.
• Westpac may amend these Conditions of Use at any time.
3.
Introducer / Broker Name
Signature
X
Section 4
Confirmation by entity that has Broker Agreement with Westpac
Principal / Director of Aggregator / Broker Group Signoff
A I confirm that the above mentioned applicant is associated with (name of entity that has Broker Agreement with Westpac) and has
completed all necessary accreditation as stipulated by Westpac.
B I will inform Westpac immediately if the above mentioned individual is no longer associated with (name of entity that has Broker
Agreement with Westpac) so that the allocated Introducer ID may be deactivated. (ID Numbers cannot be transferred between
individuals.)
Entity that has Broker Agreement with Westpac
Name
RACHEL RUIZ
Signature
X
Position
Date
/
/
Section 5
Authorisation and Allocation (For mortgage broker distribution staff use)
Westpac Signoff
I confirm that the applicant
Introducer / Applicant Name
has completed their broker training. I have checked and confirmed the applicant’s details.
Name
Signature
Date
X
/
Operations Signoff
Introducer ID allocated
I confirm that I have checked the above
applicants credentials and authorise the
allocation of an Introducer ID number
I
Name
BSB
Signature
Cost Centre
Date
Manager Number
X
/
/
Broker ID
/
BDM Name
Accreditation Training Date
/
∕
MFAA/FBAA Date
/
∕
Police Certificate Date
/
∕
Release Letter
NOTES:
Westpac Banking Corporation ABN 33 007 457 141
]
Business Review for Westpac Introducers
Business Name
Date
Email
Section 1 – UNDERSTANDING YOUR BUSINESS
What business are you writing at the moment (ie. mthly apps)?
What is your lender mix, why, and how are their current service levels?
BANK
DEAL/Mth
WHY?
SERVICE
TOTAL deal / mth:
Given all the things happening in the market what are the priorities you look for from your lender partners today? (ie service,
commission, competitive rates and products etc)
1.
2.
3.
4.
5.
6.
Your business structure
What is your experience in banking and finance?
Have you previously been a business owner?
If yes what industry?
Who is your mentor?
Your customers
What is your customer mix (ie. Percentage of First Home Buyers, Investors, Low Doc)?
CUSTOMER
No./Mth
CUSTOMER
First Home Buyers
Non conforming
Investors
Reverse Mortgage
Low Doc
Commercial
Prof Pack
Other?
No./Mth
Do you have a specific target market (product, people, area)?
Do you use a customer database? If so type / how does it work?
Page 1 of 2
BNR2
What marketing activities do you undertake?
Your referrers
What type of businesses refers to you? What type of businesses (or who) would you like to refer to you?
What product / niches have you identified that could be appropriate to this business?
Section 3 – QUALITY REVIEW
What quality ratios are you currently achieving?
Broker Estimate
Individual
(Westpac Actual)
Aggregator
(Westpac Actual)
Conversion Ratio
E Lodgment
Rework
Section 4 – PLAN FOR THE FUTURE
Do you have a business plan / Tell me about your plans for your business?
PLEASE SUPPLY BUSINESS PLAN WITH APPLICATION
What are your growth targets for your business (3 / 6 / 12 months, 2 years)?
Westpac Accreditation Retention Requirements:
New Introducers
Must submit 1 application in the
first 3 months from issuance of
an accreditation Identification
number.
All Introducers
Must settle 1 loan every 6
months to retain accreditation.
Note: Westpac may cancel the accreditation of any Introducers who do not meet the requirements. If an Introducer’s accreditation is cancelled, they
may re-apply for Westpac accreditation provided they attend a refresher training/compliance session. There is an associated fee for the refresher
training/compliance session.
Please sign below to acknowledge that you have filled in all sections above and are aware of Westpac’s Accreditation Retention
requirements:
Name:
Signature:
Date:
Page 2 of 2
BNR2
COMMERCIAL ACCREDITATIONS
Commercial Broker Application & Assessment for
Commercial Finance/Asset Finance Brokers
Submitting your Application
Complete and return the application form, assessment test and your Australian Credit Licence Number ASIC confirmation to your Commercial Broker
Manager by email or fax. If you have any queries regarding this application, please contact your Broker Manager or the ANZ Commercial Broker team
on 1300 385 269.
To BE completed by individual applying for accreditation
I am applying for:
Both a Commercial Finance & Asset Finance Accreditation
Commercial Finance Accreditation ONLY
Asset Finance Accreditation ONLY
Please note: You must have previously settled at least 4 or more Commercial or Asset Finance transactions with any recognised financial provider to proceed with your
accreditation request.
Name Company Name (if applicable)
ABN/ACN Australian Credit Licence Number (please provide your ASIC
confirmation as supporting evidence along with this application)
Address (Not PO Box)
Suburb State Postcode
Phone Number Fax
Mobile Date of Birth
Mailing Address
Suburb State Email Address
Postcode
Website (if applicable)
Previous Employers (Last 10 years)
Reference 1: (Independent Referees)Reference 2: (Independent Referees)
NameName
CompanyCompany
Phone Number
Phone Number
Email Address
Email Address
PositionPosition
Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522.
Page 1 of 7
Industry Body Memberships (attach evidence of membership held by Individual/Company)
MFAA Number
Please specify type of membership
✔
FBAA/CAFBA Number
Full
Accredited Mortgage Consultant
Other (Please give details)
To be completed by all applicants
1. Have you ever been employed by ANZ Banking Group or a related company/subsidiary?
Yes 2. Have you ever been refused accreditation by a lender? If yes, please explain:
No
Yes ✔
No
3. Have you been dismissed from an Originator company? If yes, please explain:
Yes ✔
No
4. Have you ever been declared a bankrupt or subject to a Part 10 arrangement? If yes, please explain:
Yes ✔
No
5. Have you ever been charged or convicted of an offence of dishonesty, fraud or similar? If yes, please explain:
Yes ✔
No
6. Have you ever been a Director or Office holder of an insolvent Company? If yes, please explain:
Yes ✔
No
No
7. I/We have $2M in Professional Indemnity Insurance ✔ Yes Expiry
Insurer Name For Asset Finance applicants ONLY (Not applicable for COMMERCIAL FINANCE ONLY applicants)
1. Do you agree to carry out the customer identification required by ANZ to meet Anti-Money Laundering and Counter Terrorism Financing Requirements?
Yes No
2. Do you require Authorised Business Writer to be accredited?
If yes, please complete the Authorised Business Writer details on Page 3.
Yes No
3. Do you agree to advise ANZ immediately of any additions to or exits of staff who utilise this accreditation?
Yes No
4. Whereby I/We are submitting consumer transactions, I/We hereby agree that I/We will comply with the National Consumer Credit Protection (NCCP) Act.
Yes No
I hereby certify the following:
The information provided by me is true and correct.
If I have been previously employed by Australia and New Zealand Banking Group Limited and/or its related companies (including subsidiaries),
I acknowledge that my employee records will be accessed for the purposes of assessing this application.
I/We acknowledge that, under clause 7.8 of the Accreditation Agreement between my Originator and ANZ, ANZ is entitled in certain circumstances
to recover commission paid by ANZ to my originator (and/or its members). I/We agree that, where commission has been paid by ANZ directly to
me, and where clause 7.8 requires all or part of that commission to be repaid to ANZ, I/We repay to ANZ the amount required.
Name
Signature Date (DD/MM/YYYY)
Page 2 of 7
AUTHORISED REPRESENTATIVE DETAILS - TO BE COMPLETED BY INDIVIDUALS APPLYING FOR AUTHORISED REPRESENTATIVE ACCREDITATION
Note: this is required for Asset Finance applicants only. (Not applicable to Commercial Finance Only applicants)
Sub-Originator Name
SOB
Authorised Business Writer 1
Name
Name
Address (not PO Box)
Suburb State
Email address
Date of Birth
Phone Number
Postcode
Suburb State
Email address
Date of Birth
Phone Number
Postcode
Have you ever been employed by ANZ Banking Group or a related
No
company/subsidiary?
Yes
I acknowledge that, under clause 7.8 of the Accreditation Agreement
between my Originator and ANZ, ANZ is entitled in certain circumstances
to recover commission paid by ANZ to my Originator (and/or its members).
I/We agree that where commission has been paid by ANZ directly to me,
and where clause 7.8 requires all or part of that commission to be repaid to
ANZ, I/We repay to ANZ the amount required.
No
Yes
No
company/subsidiary?
Yes
No
Yes
I hereby certify the information provided by me is true and correct.
Name
Name
Suburb State
Email address
Date of Birth
Phone Number
Postcode
Suburb Postcode
Email address
Date of Birth
Phone Number
State
No
company/subsidiary?
Yes
No
Yes
No
company/subsidiary?
Yes
No
Yes
Date (DD/MM/YYYY)
Signature I hereby certify the information provided by me is true and correct.
Date (DD/MM/YYYY)
Signature Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522.
Page 3 of 7
To be completed by Approved Originator representative
Approved Originator Company Name
Authorised Company Representative Name
Approved Originator Number
5868
RACHEL RUIZ
Phone Number
1300
346
787 Have you satisfactorily confirmed the identity of the above applicant? ✔ Yes No
Are you satisfied that the applicant has sufficient commercial expertise & will refer regular business to ANZ? ✔ Yes No
Have you completed a reference check on the above applicant? Did it prove satisfactory? ✔ Yes No
Have you completed a National Police check on the above applicant? (Please attach evidence) ✔ Yes No
Was the National Police check satisfactory? ✔ Yes No
RACHEL RUIZ
, the authorised company representative, do hereby agree that the
I,
information provided by me above is true and correct. I understand that by signing this form, I am confirming that either the Professional Indemnity
Insurance Cover of the Approved Originator Company named above will cover the above nominee, or that the Approved Originator Company named
above has confirmed that the nominee has adequate and ongoing Professional Indemnity Insurance Cover. For settled Asset Finance transactions,
pursuant to clause 7.3 of the Accreditation Agreement, I direct ANZ to pay Contract Commissions on deals originated by the Sub-Originator directly to
the Sub-Originator.
Name
RACHEL RUIZ
ANZ Internal Use only
ANZ Controlling Manager Name
Phone Number
Business Centre
Email
District
State/Broker Manager Name
Accreditation checks completed
Updated September 2010
This application does not constitute a legal binding agreement with the Bank until such time that Accreditation certificate is executed by the Bank. The Bank reserves
the right to refused accreditation as deemed appropriate. Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522.
Page 4 of 7
Commercial Finance/Asset Finance Brokers - Test
ACCREDITATION ASSESSMENT TEST
Please indicate what you are applying for:
Both a Commercial Finance & Asset Finance Accreditation (complete Section A&B)
Commercial Finance Accreditation Only (complete Section A only)
Asset Finance Accreditation Only (complete Section B only)
SECTION A: COMMERCIAL FINANCE ACCREDITATION
Please ensure all questions are answered by choosing the most appropriate answer.
Note: Pass rate is 90% - this means you need to answer 12 or more questions correctly.
1. Accredited Commercial Finance brokers approve loans on ANZ’s behalf.
True False
2. When conducting business as an Accredited Commercial Finance brokers, you are acting as an agent of the Bank.
True False
3. Which tasks are performed by an Accredited Commercial Finance brokers in the Business Loan Application Process?
a) conduct the interview
b) complete the application form
c) complete the diary note/commentary
d) collate all supporting documentation (ie balance sheet, profit & loss)
e) all of the above
4.An ANZ Approved Commercial Finance broker is automatically accredited as an ANZ Approved Mortgage Broker and therefore eligible to be paid
commission on any home loan referred to the Bank.
True False
5. Which of the following statements is true of the interest on an ANZ Business Loan?
a) it can be fixed for up to 5 years
b) it is calculated daily and charged monthly in arrears
c) charging frequencies can be monthly, quarterly, half yearly or yearly
d) all of the above
6. Business Credit Facility is available to assist with:
a) working capital
b) business investment purpose
c) purchase residential property
7. What is the Bank’s standard Loan to Valuation Ratio (LVR) on Commercial property for investment purposes?
a) 60%
d) 75%
b) 65%
e) 80%
c) 70%
8.Karen runs a business manufacturing car parts, and is seeking finance to purchase an investment commercial property costing $600,000.
With fees and other costs, she is seeking $625,000 to finance the property. In addition she has found that her business has seasonal working capital
requirements of $20,000. As security, she will have the new commercial property valued at $600,000 and her current office valued at $500,000. She
wants a set and forget medium to longer-term loan. Karen also requires a variable rate facility as she believes interest rates will fall, and wants to be
able to make extra repayments at anytime.
Which ANZ Business Products would you recommend to Karen?
a) ANZ Business Mortgage Loan & ANZ Business Credit Facility
b) ANZ Business Loan & ANZ Business Overdraft
c) ANZ Commercial Bill & ANZ Business Overdraft
d) ANZ Business Overdraft only
e) b or c
Page 5 of 7
9.Alex runs a restaurant in the city. He wants to expand his business by opening another restaurant in a nearby suburb. He requires $150, 000 to
refurbish the new premises. As security, he will use his residential home valued at $600,000 which is currently unencumbered. He requires a
variable rate facility and an offset account. Which ANZ Business Product would you recommend to Alex?
a) ANZ Business Mortgage Loan
b) ANZ Business Loan
c) ANZ Commercial Bill
d) ANZ Business Overdraft
10.All of the following forms or supporting documentation are required for Business Loan applications:
• Approved Business Originator Cover Sheet (including checklist)
• Business Acknowledgement Form
• Business Credit Application Form
• Diary Note
• Personal Statement of Position for each Director/Partner/Guarantor
• Credit Information Authority and Declaration – Applicant(s) & Guarantor(s) if applicable
• Previous 2 years Business Balance Sheets and Profit & Loss Statements
• Previous 3 years Personal Tax Returns for each Director/Partner/Guarantor
• Previous 12 months Bank Statements
True
False
11.The ANZ Manager is responsible for engaging the services of a valuer to perform valuations of property security.
True
False
12.Commercial lending must always be secured by residential or commercial property mortgages.
True
False
13.When undertaking financial analysis, commentary is required for any significant variation in P&L items (sales, profit, expenditure) and balance sheet
(assets, liabilities, retained earnings). Why is this necessary?
a) To ensure sustainability and certainty of the customer’s financial situation
b) To assist your ANZ Relationship Manager in making an informed decision
c) both A & B
14.The Bank usually require 2 years financial statements to determine operating trends.
True
False
15.Why does the Bank usually require the past 12 months Bank Statements for a refinance?
a) To determine the average account balance
b) To determine account conduct
c) To determine who the customers’ suppliers are
SBM/BM – Is assessment satisfactory?
Yes No
Page 6 of 7
SECTION B: ASSET FINANCE ACCREDITATION
Please ensure all questions are answered by circling the most appropriate answer.
Note: Pass rate is 90% - this means you need to answer 8 or more questions correctly.
1. Consider the following finance scenarios:
Chattel Mortgage
• GST is payable on the purchase price only
True
• The Lendor claims the Input Tax Credit (ITC)
False
True
False
Finance Lease • On the rentals the Lessor (borrower) claims the Input Tax Credit (ITC)
True
• GST is can be claimed on the Residual Value
False
True
False
Offer to Hire
• The borrower cannot claim the Input Tax Credit (ITC)
True
False
2. Under a Finance Lease, how are minimum residual values set?
a) in line with the ATO guidelines.
b) in line with ANZ guidelines
c) in line with Australian Accounting Standards
3. On which website would you reference the effective life of assets?
a) www.anz.com
b) www.assetlife.com.au
c) www.ato.gov.au
4.An individual without an Australian Business Number (ABN) using a motor vehicle predominantly for business use, can apply for an Offer to Hire contract?
True
False
5.Company ABC Pty Ltd has requested finance under a Chattel Mortgage and has subsequently been approved by ANZ. When requesting the tax
invoice from the supplier, how should the tax invoice be completed regarding the following:
Payable to:Delivery to:
a) ABC Pty Ltd a) ABC Pty Ltd
b) ANZ Banking Group Limited b) ANZ Banking Group Limited
6.Company ABC Pty Ltd has requested finance under an Offer to Hire and has subsequently been approved by ANZ. When requesting the tax invoice
from the supplier, how should the tax invoice be completed regarding the following:
Payable to:Delivery to:
a) ABC Pty Ltd a) ABC Pty Ltd
b) ANZ Banking Group Limited b) ANZ Banking Group Limited
SBM/BM – Is assessment satisfactory?
Yes No
Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522. Item No. 77200 09.2011 W247805
Page 7 of 7
Commercial Broker Application to Transfer Commercial Accreditation
Please complete and return this form to ANZ Commercial Broker by email: broker@anz.com or fax to 1300 554 297.
Australian Credit Licence Number
Officer Details
Name (please provide your ASIC confirmation as
supporting evidence along with this application)
Date of Birth
Address Suburb State Postcode
Business Trading name (if applicable)
Telephone Number
Facsimile Number
Mobile Number
Email Address
Previous Accreditation Details
I am accredited with ANZ Mortgage Origination: Yes No
Previous Approved Originator Numbers:
AO/SOB: SAO :
AO/SOB: SAO :
Previous Originator Company
Reason for Leaving
Sub-Approved Originator Signature
I confirm that the above details are true and correct. I understand that ANZ may contact my previous Originator Company, and may decline my transfer
request at its discretion.
Date (DD/MM/YYYY)
Signature
Note: any applications submitted under your previous Originator Company cannot be transferred to your new Originator Company.
NEW Accreditation details - TO BE COMPLETED BY AUTHORISED COMPANY REPRESENTATIVE
5868
Approved Originator AO Number
Approved Originator Company Name
Authorised Company Representative Name
RACHEL RUIZ
Originator Australian Credit Licence (ACL) Number
384704
Phone Number
1300 346 787
Have you satisfactorily confirmed the identity of the above applicant?
✔
Yes No
Are you satisfied that the applicant has sufficient commercial expertise & will refer regular business to ANZ?
✔
Yes No
Have you completed a Reference check on the above applicant? ✔
Yes No
Did it prove satisfactory? ✔
Yes No
Have you completed a Police check on the above applicant?
✔
Yes No
Was the Police check satisfactory? ✔
Yes No
Will you be authorising this sub-originator to be an Authorised Representative under the Originator’s ACL number? ✔
Yes No
authorised company representative, do hereby agree that the information provided
I,
RACHEL RUIZ
by me above is true and correct. I understand that by signing this form, I am confirming that either the Professional Indemnity Insurance Cover of the Approved
Originator Company named above will cover the above nominee, or that the Approved Originator Company named above has confirmed that the nominee has
adequate and ongoing Professional Indemnity Insurance Cover.
Signature
BANK USE ONLY
Approved: No
Yes New Approved Originator AO/SAO
Date (DD/MM/YYYY)
Date (DD/MM/YYYY) Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522. Item No. 77225 05.2011 W229116
Updated April 2011
Page 1 of 1
✔
✔
✔
✔
✔
✔
✔
✔
RACHEL RUIZ
Level 14, Castlereagh Street
Sydney
NSW
✔
2000
✔
✔
✔
Commercial Broker Application Form
(INDIVIDUAL)
This application is an important step to becoming accredited with St.George Corporate & Business Bank’s
Intermediary Business. Upon acceptance and approval of this Application, you may proceed to the next stage
covering a broker agreement.
This form is only applicable if you wish to operate as a broker in your individual name.
Please complete ALL Sections of this form
Please type or print clearly with a black pen
Once completed, please forward the completed application with relevant documentation via email to:
cbbintermediarybusiness@stgeorge.com.au
Or send to:
St.George Bank
Intermediary Distribution
Level 7, 17 York Street
Sydney NSW 2000
Each application is subject to assessment. This application does not constitute a commercial agreement and
St.George may, in its absolute discretion refuse to approve an application.
St.George Bank – A Division of Westpac Banking Corporation ABN 33 007 457 141 AFSL 233714
1
Section A
Are you applying as a (Please tick one box below and fill out the relevant details):
Aggregator Member
✔
Aggregator Group Name:
1. Are you currently a member of MFAA and/or FBAA?
If yes, please attach a copy of the relevant membership certificate(s)
No
Yes
✔
Attachment
✔
2. Do you have Professional Indemnity (PI) Insurance cover?
If yes, please attach copy of cover certificate
No
Yes
✔
Attachment
✔
Attachment
✔
NB: Copies of certificate(s) provided must have a current validity date
If you have current PI insurance then attach certificate showing the amount
the applicant is covered for and the expiry including “run-off” cover
3. Identification
Please attach two (2) forms of Identification for each individual applicant.
NB: At least one form of ID must contain applicants name and their residential address
and/or D.O.B. If you are unsure about documents that qualify, please contact your
Business Development Manager.
4. Do you hold Credit Ombudsman Service Ltd (COSL) or other
External Dispute Resolution (EDR) scheme membership?
If yes, please attach a copy of the certificate OR proof of membership
of an alternate External Dispute Resolution (EDR) scheme, and/or
written approval by COSL.
No
Yes
✔
Attachment
✔
No
Yes
✔
Attachment
✔
NB: Copy of certificate provided must have a current validity date
5. Do you hold an Australian credit licence or authorisation as a
credit representative from a licensee?
Please attach a copy of your relevant Licence certificate that evidences
you are a Licensed Finance Broker under the NCCP Act 2009
2
Section B
ALL sections to be completed by applicants.
Title: Mr
Mrs
Ms
Miss
Other
First Name:
Last Name:
Date of Birth (dd/mm/yyyy):
/
/
Organisation Name (if applicable):
Position held (if applicable):
Residential Address (PO Box not allowed):
Address:
Suburb/City:
State:
Full Address of Principal Place of Business:
Post Code:
Same as above OR
Address:
Suburb/City:
State:
Postal address:
Country:
Post Code:
Same as above OR
Address:
Suburb/City:
Telephone: (
State:
)
Fax: (
Post Code:
Mobile:
)
Email address:
Website address:
NB: At least one form of ID must contain applicants name and their residential address and/or D.O.B.
If you are unsure about documents that qualify, please contact your Business Development Manager.
3
Section C (1)
Personal Declaration
In relation to the last 10 years, whether as an individual or Director of a company or partner of a firm, have
you ever (please tick relevant box):
a) Had an industry or business licence, issued by a Proper Authority, either refused,
suspended, withdrawn, cancelled or been subject to banning order, or do you
have any of these actions pending?
Yes
No
b) Been convicted of or found to have committed an offence concerning fraud or
dishonesty or do you have a charge pending involving fraud or dishonesty?
Yes
No
c) Been subject to an investigation by ASIC or by any other regulatory or official
Body in relation to any aspect of its business or are you currently subject to such
an investigation by any of these bodies?
Yes
No
d) Been a director of a company that has gone into voluntary liquidation or to which
a Receiver, Provisional liquidator, Liquidator, Scheme Manager or an Official
Manager has been appointed while you were a Director, or within six months
after you ceased to be a Director, or do you have any such action pending?
Yes
No
e) Been declared bankrupt or are you presently an un-discharged bankrupt or do
you have any such action pending?
Yes
No
Been a Partner of a firm which has been placed into voluntary liquidation or had
a Receiver Provisional liquidator, Liquidator, Scheme Manager or an Official
Manager appointed, or do you have any such action pending?
Yes
No
g) Been refused membership of a statutory, professional or other body in respect of
your professional capacity or other Body in respect of your professional capacity,
or do you have such action pending?
Yes
No
h) Been subject to disciplinary proceedings or banned, disqualified or expelled by a
statutory, professional or other Body in respect of your professional capacity, or
do you have such action pending?
Yes
No
f)
i)
Been dismissed, or had any proper authority including any licence withdrawn on
ethical or legal grounds, or any disciplinary proceedings pending?
Yes
No
j)
Had any past, present or pending claim made against your Professional
Indemnity Insurance under which you operate in relation to advice you have
provided?
Yes
No
Yes
No
Yes
No
Yes
No
k) Been refused Professional Indemnity Insurance?
l)
Had your accreditation cancelled or suspended by a Lender, Mortgage Manager,
or a Mortgage Insurer, other that for volume reasons, or had your membership of
an aggregator or franchise group terminated, or is similar action pending against
you?
m) Have you as an individual ever been known by any other name?
If you have answered “Yes” to any of the above questions from (a) to (m), please attach details as to why you
answered “Yes” and any details relating to the incident.
4
Section C (2)
Privacy Disclosure Statement and Consents
Your right to privacy is important to us. This statement explains your privacy rights and our rights and
obligations in relation to your personal information.
Your rights
You need not give us any of the personal information requested in this form or any other document or
communication relating to this application. However, without this information, we may not be able to process
the request or provide an appropriate level of service.
You may request access at any time to personal information held by us about you and may ask us to correct it
if you believe it is incorrect or out of date.
How we use your personal information
process the Commercial Broker Application Form (including performing the identity checks);
administer and manage the accreditation process and
facilitate our internal business operations, including fulfilment of any legal requirements and confidential
systems maintenance and testing.
We may disclose your personal information in the following circumstances:
to any referee nominated by you;
to our external service providers that provide services for the purposes only of our business on a
confidential basis, for example a mailing house;
to any person acting on your behalf, including your financial advisor, broker, solicitor or accountant,
unless you tell us not to;
in connection with a proposed sale or acquisition of an interest in a business and
if you request us to do so or if you consent (for example for a direct debit) or where the law requires or
permits us to do so.
Use by the St.George Group* of Companies
We may also use your personal information or give access to personal information about you to any member
of the St.George Group* including to:
assess your total relationship and product holding with the St.George Group*, analyse products and
customer needs and develop new products.
By signing this form you authorise us to collect, maintain, use and disclose your personal information in the
manner set out in this Privacy Statement.
By completing this form, you undertake to provide a copy of this Privacy Statement to each principal,
company officer or partner that you purport to represent.
* Note: St.George Group means any related body corporate of St.George Bank a division of Westpac Banking
Corporation A.B.N. 33 007 457 141.
I declare that the information given in this application is complete, true and correct:
First Name:
Last Name:
Signature: ………………………………………………….. Date
/
/
5
Commercial Broker Application Form
(COMPANY, CORPORATION OR PARTNERSHIP)
This application is an important step to becoming accredited with St.George Corporate & Business Bank’s
Intermediary Business. Upon acceptance and approval of this Application, you may proceed to the next stage
covering a broker agreement.
This form is only applicable if you wish to operate as a broker in your company name.
Please complete ALL Sections of this form
Please type or print clearly with a black pen
Once completed, please forward the completed application with relevant documentation via email to:
cbbintermediarybusiness@stgeorge.com.au
Or send to:
St.George Bank
Intermediary Distribution
Level 7, 17 York Street
Sydney NSW 2000
Each application is subject to assessment. This application does not constitute a commercial agreement and
St.George may, in its absolute discretion refuse to approve an application.
1
Section A
Are you applying as a (Please tick one box below and fill out the relevant details):
Aggregator Member
Aggregator Group
✔
1. Are you currently a member of MFAA and/or FBAA?
If yes, please attach a copy of the relevant membership certificate(s)
No
Yes
✔
Attachment
✔
2. Do you have Professional Indemnity (PI) Insurance cover?
If yes, please attach copy of cover certificate
No
Yes
✔
Attachment
✔
Attachment
✔
NB: Copies of certificate(s) provided must have a current validity date
If you have current PI insurance then attach certificate showing the amount
the applicant is covered for and the expiry including “run-off” cover
3. Identification
NB: At least one form of ID must contain applicants name and their residential address
and/or D.O.B. If you are unsure about documents that qualify, please contact your
Business Development Manager.
4. Do you hold Credit Ombudsman Service Ltd (COSL) or other
External Dispute Resolution (EDR) scheme membership?
If yes, please attach a copy of the certificate OR proof of membership
of an alternate External Dispute Resolution (EDR) scheme, and/or
written approval by COSL.
No
Yes
✔
Attachment
✔
No
Yes
✔
Attachment
✔
5. Do you hold an Australian credit licence or authorisation as a
credit representative from a licensee?
Please attach a copy of your relevant Licence certificate that evidences
you are a Licensed Finance Broker under the NCCP Act 2009
2
Section B (1)
ALL sections to be completed if you are applying for membership for a Company, Corporation or Partnership
ABN
ACN
Organisation Name:
Name of Corporate / Legal entity:
State of Incorporation:
Full Address of Registered Office:
Street Address:
Suburb/City:
State:
✔
Post Code:
Same as above OR
Address:
Suburb/City:
State:
Postal address:
Country:
Post Code:
Same as above OR
Address:
Suburb/City:
Telephone: (
State:
)
Fax: (
Post Code:
Mobile:
)
Email address:
Website address:
3
Section B (2)
Signed by the Applicant/s:
Signatory
Requirements
Company Directors/Secretary
Must be signed by a minimum of two (2) Company
Directors/Secretary
Sole Director or Sole Company Secretary
One (1) person to sign (that person affirms that he/she has
signed in the capacity of Sole Director and Sole Company
Secretary of the company)
COMPANY EXECUTION
Signed for and on behalf of
by authority of the Directors.
(Name of Corporate/Legal entity)
Signatory 1
Signatory 2
Signature
Signature
Director/Secretary
Director/Secretary
Print Name
Date
Print Name
/
/
Date
/
/
SOLE TRADER/PARTNERSHIP
Signed for and on behalf of
(Name of Corporate/Legal entity)
Signatory 1
Signatory 2
Signature
Signature
Director/Secretary
Director/Secretary
Print Name
Date
Print Name
/
/
Date
/
4
/
Section C (1)
Institutional / Partnership Contacts
Each Director/Secretary, Partner and Loan Writer must complete this section and sign the Personal
Declaration (Section C (2)) and the Privacy Disclosure Statement and Consents (Section C (3)).
(Complete a separate form for each individual)
Title: Mr
Mrs
Ms
Miss
Other
First Name:
Last Name:
Position held: Sole Director
Date of Birth (dd/mm/yyyy):
Director
/
Partner
Other
- specify
/
Residential Address (PO Box not allowed):
Address:
Suburb/City:
State:
Post Code:
Organisation Name:
Street Address:
Suburb/City:
Telephone: (
State:
)
Fax: (
Country:
Australia
Mobile:
)
Email address:
NB: At least one form of ID must contain applicants name and their residential address and/or D.O.B.
If you are unsure about documents that qualify, please contact your Business Development Manager.
5
Post Code:
Section C (2)
Personal Declaration
In relation to the last 10 years, whether as an individual or Director of a company or partner of a firm, have
you ever (please tick relevant box):
a) Had an industry or business licence, issued by a Proper Authority, either refused,
suspended, withdrawn, cancelled or been subject to banning order, or do you
have any of these actions pending?
Yes
No
b) Been convicted of or found to have committed an offence concerning fraud or
dishonesty or do you have a charge pending involving fraud or dishonesty?
Yes
No
c) Been subject to an investigation by ASIC or by any other regulatory or official
Body in relation to any aspect of its business or are you currently subject to such
an investigation by any of these bodies?
Yes
No
d) Been a director of a company that has gone into voluntary liquidation or to which
a Receiver, Provisional liquidator, Liquidator, Scheme Manager or an Official
Manager has been appointed while you were a Director, or within six months
after you ceased to be a Director, or do you have any such action pending?
Yes
No
e) Been declared bankrupt or are you presently an un-discharged bankrupt or do
you have any such action pending?
Yes
No
Been a Partner of a firm which has been placed into voluntary liquidation or had
a Receiver Provisional liquidator, Liquidator, Scheme Manager or an Official
Manager appointed, or do you have any such action pending?
Yes
No
g) Been refused membership of a statutory, professional or other body in respect of
your professional capacity or other Body in respect of your professional capacity,
or do you have such action pending?
Yes
No
h) Been subject to disciplinary proceedings or banned, disqualified or expelled by a
statutory, professional or other Body in respect of your professional capacity, or
do you have such action pending?
Yes
No
f)
i)
Been dismissed, or had any proper authority including any licence withdrawn on
ethical or legal grounds, or any disciplinary proceedings pending?
Yes
No
j)
Had any past, present or pending claim made against your Professional
Indemnity Insurance under which you operate in relation to advice you have
provided?
Yes
No
Yes
No
Yes
No
Yes
No
k) Been refused Professional Indemnity Insurance?
l)
Had your accreditation cancelled or suspended by a Lender, Mortgage Manager,
or a Mortgage Insurer, other that for volume reasons, or had your membership of
an aggregator or franchise group terminated, or is similar action pending against
you?
m) Have you as an individual ever been known by any other name?
If you have answered “Yes” to any of the above questions from (a) to (m), please attach details as to why you
answered “Yes” and any details relating to the incident.
6
Section C (3)
Privacy Disclosure Statement and Consents
Your right to privacy is important to us. This statement explains your privacy rights and our rights and
obligations in relation to your personal information.
Your rights
You need not give us any of the personal information requested in this form or any other document or
communication relating to this application. However, without this information, we may not be able to process
the request or provide an appropriate level of service.
You may request access at any time to personal information held by us about you and may ask us to correct it
if you believe it is incorrect or out of date.
How we use your personal information
process the Commercial Broker Application Form (including performing the identity checks);
administer and manage the accreditation process and
facilitate our internal business operations, including fulfilment of any legal requirements and confidential
systems maintenance and testing.
We may disclose your personal information in the following circumstances:
to any referee nominated by you;
to our external service providers that provide services for the purposes only of our business on a
confidential basis, for example a mailing house;
to any person acting on your behalf, including your financial advisor, broker, solicitor or accountant,
unless you tell us not to;
in connection with a proposed sale or acquisition of an interest in a business and
if you request us to do so or if you consent (for example for a direct debit) or where the law requires or
permits us to do so.
Use by the St.George Group* of Companies
We may also use your personal information or give access to personal information about you to any member
of the St.George Group* including to:
Assess your total relationship and product holding with the St.George Group*, analyse products and
customer needs and develop new products.
By signing this form you authorise us to collect, maintain, use and disclose your personal information in the
manner set out in this Privacy Statement.
By completing this form, you undertake to provide a copy of this Privacy Statement to each principal,
company officer or partner that you purport to represent.
* Note: St.George Group means any related body corporate of St.George Bank a division of Westpac Banking
Corporation A.B.N. 33 007 457 141.
I declare that the information given in this application is complete, true and correct:
First Name:
Last Name:
Signature: ………………………………………………….. Date
/
/
7
Westpac Banking Corporation ABN 33 007 457 141
Westpac Financial Services Partnerships - ID Request Form
This application is for Individual Introducer – Westpac Business Broker
Instructions: Please complete Sections 1 to 6 in full.
Incomplete requests cannot be accepted.
Fax completed form to your Westpac Manager in your state.
Do you have an existing ID number? Yes
No If yes, please supply your Introducer ID no.
I
Section 1 – Introducer Details
Title
Given Name/Middle Name(s)
Date of Birth
Surname
Residential Address (No PO Boxes)
State Office Number
Mobile Number
Postcode
Fax Number
Mother’s Maiden Name (for security purposes)
Email Address
Other Banks Associated With
Section 2 – Company Details
Your Company Name
Trading Name (if applicable)
Nature of Business: eg. Accountant, financial planner
Your Company Address (where you operate from)
State Page 1 of 3
Postcode
P/C 1578 (1/09) • Intranet)
Section 3 – Condition of Use
1) I agree to be responsible for all usage of my allotted Introducer ID Number.
2)I acknowledge that I am only authorised to refer or submit loan applications that I am directly involved in.
Under no circumstances will I submit or refer loan applications on behalf of other referrers or brokers using
my introducer ID number.
3) I agree to stop using my Introducer ID Number immediately upon ceasing my employment / association with the above
mentioned company.
4) I enclose my Police Clearance Certificate and evidence of FBAA or AAFA membership (if held).
5) I warrant that, if I have provided information regarding a 3rd party in conjunction with this application, I have obtained all
necessary consents and complied with any requirements of the Privacy Act 1988. 6) I consent to Westpac collecting and providing my personal information to its related entities and service providers. I agree
that Westpac and its related entities will use my personal information to provide me with information which is essential to me
providing introducer services.
I also consent to Westpac or its related entities providing me with additional advertising or promotional material regarding
products or services offered by Westpac or its related entities. (If you do not wish to receive additional advertising or promotional material, if you would like details of personal information
which Westpac may hold about you, or for a full copy of the Westpac privacy policy, please contact your Westpac Business
Development Manager or visit www.westpac.com.au).
Introducer Signature
Date
/
/
Section 4 – Group Details
Name of Entity that has signed Broker Agreement with Westpac
Section 5 – Principal/Director Sign-off
This section requires sign off by the name of entity that has signed Broker Agreement with Westpac.
Delete declaration if not applicable (ie. if individual is your direct employee, delete declaration B)
A. (1) I confirm that the above mentioned applicant is my direct employee and has completed all necessary accreditation as
stipulated by Westpac.
(2) I will inform Westpac immediately if the above mentioned individual leaves my employ so that the allocated Introducer
ID may be deactivated. (ID Numbers cannot be transferred between employees.)
OR
B. (1) I confirm the above mentioned applicant is associated with (name of entity that has Broker Agreement with Westpac)
and has completed all necessary accreditation as stipulated by Westpac.
(2) I will inform Westpac immediately if the above mentioned individual is no longer associated with (name of entity that
has Broker Agreement with Westpac) so that the allocated Introducer ID may be deactivated. (ID Numbers cannot be
transferred between individuals.)
Group Name
Title
Name
Signature
RACHEL RUIZ
Date
/
/
Return completed forms to your Westpac Manager
Page 2 of 3
P/C 1578 (1/09) • Intranet)
Section 6 – Authorisation By Westpac
Westpac Manager Checklist
For all new introducers, a Police Certificate not more than 6 months old is attached.
I have checked this request form is completed in full and the information provided is legible.
I have supported and signed this request.
I have checked that Section 5 has been signed by the entity which has signed the Broker Agreement with Westpac.
I have checked that Section 5 declaration A or B has been deleted.
Westpac Manager:
I support the application
based on the information
provided herein.
Consumer &
Business Services
Introducer ID allocated
I confirm that I have checked
the applicant’s credentials
and authorise allocation of
an Introducer ID Number.
BSB
Name
Name
Signature
Signature
I
Request Date
Manager Number
Broker ID Number
Is this introducer under a Co-branding arrangement?
Page 3 of 3
P/C 1578 (1/09) • Intranet)