Application Form

Entity Name(Legal/Corporate Name)

Trading As:

ABN:

Business Address:

Business Telephone Number:

Suburb:

State

Postcode

Email Address:

Owner Information

Applicants Full Name(as it appears on your driver licence):

Title

Percentage of business owned:

Telephone number(Mobile):

Home Address

Suburb:

State

Postcode

How long have you been at this address?

Date of Birth

Authorised Second Point of Contact

excluding any directors or shareholders associated with the business

Contact Name:

Contact Number:

Contact Name(if applicable):

Contact Number:

Estimated time remaining on lease/mortgage

Who do you pay the rent/mortgage to?

What are your current monthly repayments?

Years

Months

Business Property Information

Business Trade References

Business Name

Contact Person

Contact Number

Applicants Declaration

Applicant Name

Date

Applicant Signature

Upload your proof of I.D such as the front and back of your driver licence, Medicare Card, Australian Passport

Upload File

By ticking this box, I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may render for refusal of this application”.

The Applicant consents to BizFund Pty Limited collecting its personal information from a credit reporting body for the purposes of assessing this application. Such personal information may include information about the Applicant’s credit worthiness, credit standing, credit history or credit capacity. The Applicant authorises BizFund Pty Limited to use any information derived from that report in assessing this application and for any purposes permitted under the Privacy Act 1988. The Applicant authorises BizFund Pty Limited to make any additional checks that BizFund Pty Limited sees fit to continue the credit assessment. The Applicant agrees that BizFund Pty Limited may give to and seek from any credit providers named in this credit application and any credit providers that may be named in a credit report issued by a credit reporting agency information about the Applicant’s credit arrangements. The Applicant acknowledges that BizFund Pty Limited may share the Applicant’s personal information to the agents, associates and third-party funders of BizFund Pty Limited for the purpose of assessing this Application and the Applicant consents to BizFund Pty Limited using the Applicant’s personal information in this way. To the maximum extent permitted by law, BizFund Pty Limited excludes all liability in connection with the use by any third party of the Applicant’s personal information.

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