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SECURED LOAN APPLICATION FORM
Loan Amount	$	SECURITY DETAIL
Borrower/Broker Name :	Surname: First Name:	Type of security
Phone:		Address of property
Mobile		Market value	$
Email		Existing Debt	$

How did you hear about us?		Preffered contact
Comments		I acknowledge that under the Privacy Act 1988, Financial Express Pty Ltd is allowed to disclose to a credit reporting agency personal information contained in this application or otherwise acquired by Financial Express Pty Ltd and about the conduct of my credit account. Provided that Financial Express Pty Ltd does so in a manner and for purposes that conform with the Privacy Act, I agree to Financial Express Pty Ltd obtaining information about my commercial activities and commercial credit worthiness from a business which provides information about the commercial credit worthiness of persons, and to using that information in assessing my application form. Provided that Financial Express Pty Ltd does so in a manner and for purposes that conform with the Privacy Act, I also agree to Financial Express Pty Ltd giving to and receiving from any credit providers names in this credit application and any credit my credit arrangements, as long as the information is given or received to assess an application for credit made by me to the recipient credit provider or to assess my credit worthiness. Provided that Financial Express Pty Ltd does so in a manner and for purposes that conform with the Privacy Act, I also agree to Financial Express Pty Ltd obtaining a credit report containing personal information about me from a credit reporting agency and to using that report or any information derived from the report in assessing this application, and for any other purposes permitted under the Privacy Act. I acknowledge that my personal information may include textual data and images of personal documents such as my driver???¤s license, passport and bank statements, and that this data may be stored on a internet based private computer network accessible to authorized representative of Financial Express Pty Ltd and is subject to the provisions of the Privacy Act. I acknowledge that the company has taken all practicable precautions to protect this information from unauthorized disclosure or abuse. I acknowledge that subject to the provisions of the Privacy Act, Financial Express Pty Ltd may otherwise disclose to any person any information concerning a credit facility granted to me or the conduct of that credit account. I acknowledge that Financial Express Pty Ltd may contact any person (for example my employer) to verify any information contained in this application. I agree to this statement.
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