Originator Application

Transcription

1 Bankwest Business Lending Originator Application For Business Lending F224-1 October 2012 Happy Banking Page 1 of 18 BWA-F (LF19.LF20.F196.F222)

2 Business Loan Application Checklist Bank/Broker use only Please complete the details below Broker details Aggregator name Application/Mandate Fee paid Postal address Phone number ( ) Broker ID Facsimile number ( ) Broker address General Broker Application Checklist Commitment Fee. A cheque for a minimum of 0.25% of the loan amount required upfront or attach Direct Debit Request covering Application/Mandate Fee Instruction Worksheet Business or Investment Purpose Declaration/other information Details of Applicants/Guarantors Form Privacy Statement and Consent Form Customer Identification Procedure completed for borrowers/signatories Initial Disclosure Statement Non-Financial Questions Corporate Structure Diagram (if applicable) Financial A schedule of current Loan/HP/Lease commitments for corporate/trust borrower(s) and guarantor(s) Serviceability worksheet (Debt Service Calculator) Past two years Profit and Loss Statements and Balance Sheets for the borrower(s) and guarantor(s) if applicable, together with individual taxation returns for the director(s)/borrower(s). (If proposal or all borrowing is greater than 1 million, past three years financials are required) Bank trading statements for last six months and loan account statements covering the last 12-month period Cash flow forecast (if applicable) Full copy of Trust Deed Property Full copies of commercial property lease(s) (if applicable) Full copy of signed Contract of Sale/Offer and Acceptance (if applicable)) Property Insurance details: company and policy number (if applicable) Rates notices (with title particulars) for existing security Building contract and plans (residential construction loans only) Miscellaneous Does corporate borrower s/guarantor s constitution require loan documentation to be executed under company seal (if applicable)? Can applicant(s) speak/understand English? Interpreter certificate required? Will documents be signed under power of attorney? If yes, please provide a registered copy of power of attorney Does the customer have any special needs in regards to signing and witnessing documents? If yes, please advise in comments section General comments Documents/Loan contracts to be forwarded to (customer or originator): Page 2 of 18 BWA-F (LF19.LF20.F196.F222)

3 Application for Business Finance Bankwest Business Important Information Please complete using BLOCK letters. Section 1 Applicant Details of Business Account (Company, Partnership, Trust, Club or Association) Trading as Postal address Contact name address Contact number ACN/ABN Specific industry No of employees ( ) Section 2 Purpose of Loan Section 3 Loan Details Indicate the type and amount of finance required. Facility type (i.e. Overdraft) Amount Please tick where applicable Term Principal and Interest Interest Only Principal and Interest Interest Only Principal and Interest Interest Only Principal and Interest Interest Only Principal and Interest Interest Only Brief description of offered security (residential property, commercial property, debenture, etc.) Address Volume/Folio No. Insurance details Supporting documentation Copies of the following current documents should accompany this form. Please tick. Business lending Business Name Search Company lending Company Search Trust lending Copy of Trust Deed (for total lending exceeding 3 million) Society/Association Copy of Constitution/Rules/By-Laws and/or Minutes of last meeting Financial information Past 3 years business financials Including Profit and Loss Statement and Balance Sheet Bank statements for non-bankwest trading and loan accounts for the previous 12 months Cash flow budget projection Personal taxation returns for individuals associated with the Business Copies of valuation reports for any property offered as security Aged creditor and debtors listing Page 3 of 18 BWA-F (LF19.LF20.F196.F222)

4 Section 4 Accountant Details Name Address Telephone number ( ) ( ) Facsimile number Section 5 - Contingent liabilities Have owners/partners/directors provided guarantees or security to support any debt or liability not disclosed in the supplied Balance Sheet? Yes (give details) No Have owners/partners/directors, in any capacity, ever been bankrupt, insolvent, under administration, had their estate assigned or had an unsatisfied judgement against them for debt? Yes (give details) No Privacy Statement and Consent to Use Your Information This statement explains how Bankwest ( we/us/our ) collects, uses and discloses personal information and provides your consent for us to send communications about products and services. Personal information is information about and which identifies an individual, including information about credit worthiness, standing, history and capacity. When you give us personal information about another person, you represent that you are authorised to do so and agree to inform that person who we are, that we will use and disclose that information for the relevant purposes set out below and that they can access the information we hold about them. You should also refer to our Privacy Policy at 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 a facility may be held and used by us to assess and process the application for the facility, establish, provide and administer the facility, execute your instructions and, as relevant, comply with legislative/regulatory requirements, consider other applications you make, perform administrative tasks including systems development, testing, credit scoring and training, manage our rights/obligations regarding external payment 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. membership of a professional or trade association). We are required by law to collect information to identify and verify you. Also, without your information, we may not be able to provide a facility. 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, beneficiary if you are a trustee, guardian or attorney, law enforcement, regulatory and government bodies, anyone who introduces you to us, 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. Applications for credit In addition, if we are assessing an application for credit or whether to accept you as a guarantor, or are administrating a credit facility, you agree we may at any time collect personal information about you from, and disclose it to, financial institutions, credit providers, Personal Properties Securities Register, credit reporting agencies, debt collecting agencies, any mortgage insurer we use and their reinsurer, your current and prospective co-borrowers, sureties, guarantors and co-guarantors, any person considering purchasing or who purchases, funds or manages the loan or security and their advisers. 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 Unless you ask us, by calling , 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. Receiving commercial electronic messages You consent to us sending commercial electronic messages (including messages about our products and services and the products and services of any third party) to any electronic address which you provide or for which you are responsible. You warrant that you have authority, either as or on behalf of the electronic account holder, to provide this consent and agree that until you withdraw your consent by providing written notice to us or using an unsubscribe facility in the message, we may continue to send commercial electronic messages to those addresses. Page 4 of 18 BWA-F (LF19.LF20.F196.F222)

5 Section 6 - Business Purposes Declaration Important: You should only sign this declaration if this loan is wholly or predominantly for Business purposes; or Investment purposes other than investment in residential property. By signing this declaration you may lose your protection under the National Credit Code. (To be signed by individuals, sole traders, individuals acting as trustees, partners and strata corporations where the declaration is correct.) I/We declare that the amount of credit to be provided to me/us by the Bank is to be applied wholly or predominantly for: business purposes; or investment purposes other than investment in residential property. Page 5 of 18 BWA-F (LF19.LF20.F196.F222)

6 Section 7 - Declaration I/We have read, understood and accept the Bank s Privacy Statement and Consent form (refer page 2). I/We agree that if the Bank approves a loan pursuant to this application, I/we will pay legal costs and disbursements incurred by the Bank on this matter to external legal advisers and legal advisors employed by the Bank whether or not I/we accept such a loan. The Bank can retain (if already paid by me/us) and recover from me/us any establishment, government and bank fees associated with this application. I/We acknowledge that the Bank may receive or pay commissions in respect of this application. I/We declare that the information in the application is true and correct and I/we have not withheld any information which may affect the Bank s decision. I/We acknowledge that the provision of false information may lead to the cancellation of the facilities granted. Signing instructions If the application is made on behalf of a sole trader, the sole proprietor must sign. If the application is made on behalf of a company, either the sole director (who is also the company secretary), or 2 directors, or a director and the company secretary must sign. If the application is made on behalf of a partnership, all proprietors of the business entity must sign unless the Partnership Agreement provides otherwise. If the application is made on behalf of a Trust, all trustees must sign. Where the trustee(s) is/are company(ies), two directors or a director and secretary of each trustee company must sign. If the application is made on behalf of any other entity, please specify the entity (including the authority upon which the signature is given). * Incorporated entities are to sign For and on behalf of. (i.e. Director/Partner) (i.e. Director/Partner) (i.e. Director/Partner) (i.e. Director/Partner) (i.e. Director/Partner) (i.e. Director/Partner) To assist in providing the best financial solution for your business, please indicate if we can help with any of the following services: Business Insurance Commercial Credit Cards Import or export finance Equipment financing by way of Lease, Hire Purchase or Chattel Mortgage Merchant Facilities: EFTPOS terminal(s) for accepting payments from customers Online Business Banking Periodical Payments Settlement and conveyancing services Telephone Banking Discuss superannuation with an expert for either yourself or your staff. Page 6 of 18 BWA-F (LF19.LF20.F196.F222)

7 Customer Details Applicants/Guarantors/Directors/Partners for Business Lending Personal Details Person 1 Person 2 Family name Family name Given name(s) Given name(s) Marital status of birth Marital status of birth Capacity Proprietor Director/Secretary Partner Trustee Capacity Proprietor Director/Secretary Partner Trustee Guarantor Other (please specify) Guarantor Other (please specify) Residential address Residential address Postcode Postcode Years there Contact telephone number Years there Contact telephone number address address Postal address (if different from above) Postal address (if different from above) Postcode Postcode Previous address (if less than 3 years at present) Previous address (if less than 3 years at present) Postcode Postcode Years there Age of dependants Years there Age of dependants Occupation Work telephone number Occupation Work telephone number Current employment status (please tick) Self-employed Full time Part time Casual Unemployed Retired Other Present employer Years there Current employment status (please tick) Self-employed Full time Part time Casual Unemployed Retired Other Present employer Years there Previous employer (if less than 3 years at present) Years there Previous employer (if less than 3 years at present) Years there Income details Income derived from the borrowing business entity Description Other income description Gross annual amount p.a. p.a. p.a. p.a. Note (i) For PAYE income, please provide copies of two recent payslips or last year s payment summary or tax return. (ii) For rental income, please provide copy of Lease(s) or signed letter from Property Agent confirming current and/or expected rental income. (iii) For any other income, please provide documented evidence. Are you ordinarily resident in Australia? Yes No Note To be ordinarily resident you must either: (i) hold an Australian passport or citizenship, or (ii) have been living in Australia for at least 200 days in the last 12 months and there is no legal reason preventing the application/guarantor from remaining in Australia indefinitely. Income details Income derived from the borrowing business entity Description Other income description Gross annual amount p.a. p.a. p.a. p.a. Note (i) For PAYE income, please provide copies of two recent payslips or last year s payment summary or tax return. (ii) For rental income, please provide copy of Lease(s) or signed letter from Property Agent confirming current and/or expected rental income. (iii) For any other income, please provide documented evidence. Are you ordinarily resident in Australia? Yes No Note To be ordinarily resident you must either: (i) hold an Australian passport or citizenship, or (ii) have been living in Australia for at least 200 days in the last 12 months and there is no legal reason preventing the application/guarantor from remaining in Australia indefinitely. Page 7 of 18 BWA-F (LF19.LF20.F196.F222)

8 What you own (Assets) Home at Other property/land at Savings (institution and branch) Motor vehicle (year, make and model) Other assets/investments (e.g. equity in business/shares/companies/superannuation/life insurance (redeemable value)) Estimated value What you owe (Liabilities and repayments) Consumer loans (housing/personal loans) To be cleared and closed Monthly payments Balance owing Lender Yes No Lender Yes No Lender Yes No Business loans (overdraft/leases/hire purchase) Lender Yes No Lender Yes No Lender Yes No Other Lender Yes No Lender Yes No Credit cards/store accounts (including nil balance accounts) Lender Limit Yes No Lender Limit Yes No Lender Limit Yes No Rent Maintenance Provide details of any guarantees given or any contingent liabilities for which you may become liable. Total Have you ever been bankrupt, insolvent, under administration or had an unsatisfied judgement against you for debt? Yes No If Yes please give details Total (Note: The following declaration is to be signed by individuals, sole traders, individuals acting as trustees, partners and strata corporations where the declaration is correct) I/We declare that the amount of credit to be provided to me/us by the Bank is to be applied wholly or predominantly for: business purposes; or investment purposes other than investment in residential property. Important: You should only sign this declaration if this loan is wholly or predominantly for Business purposes; or Investment purposes other than investment in residential property. By signing this declaration you may lose your protection under the National Credit Code. Page 8 of 18 BWA-F (LF19.LF20.F196.F222)

9 Privacy Statement and Consent Use of your information Privacy Statement This Statement explains how Bankwest ( we/us/our ) collects, uses and discloses personal information and provides your consent for us to send communications about products/services. Personal information is information about and which identifies an individual, including information about credit worthiness, standing, history and capacity. When you give us personal information about another person, you represent that you are authorised to do so and agree to inform that person who we are, that we will use and disclose that information for the relevant purposes set out below and that they can access the information we hold about them. You should also refer to our Privacy Policy at 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 a facility may be held and used by us to assess and process the application for the facility, establish, provide and administer the facility, execute your instructions and, as relevant, comply with legislative/regulatory requirements, consider other applications you make, perform administrative tasks including systems development, testing, credit scoring and training, manage our rights/obligations regarding external payment 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. membership of a professional or trade association). We are required by law to collect information to identify and verify you. Also, without your information, we may not be able to provide a facility. 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, beneficiary if you are a trustee, guardian or attorney, law enforcement, regulatory and government bodies, anyone who introduces you to us, 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. Applications for credit In addition, if we are assessing an application for credit or whether to accept you as a guarantor, or are administrating a credit facility, you agree we may at any time collect personal information about you from, and disclose it to, financial institutions, credit providers, credit reporting agencies, debt collecting agencies, any mortgage insurer we use and their reinsurer, your current and prospective co-borrowers, sureties, guarantors and co-guarantors, any person considering purchasing or who purchases, funds or manages the loan or security and their advisers. 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 Unless you ask us, by calling , 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. Receiving commercial electronic messages You consent to us sending commercial electronic messages (including messages about our products and services and the products and services of any third party) to any electronic address which you provide or for which you are responsible. You warrant that you have authority, either as or on behalf of the electronic account holder, to provide this consent and agree that until you withdraw your consent by providing written notice to us or using an unsubscribe facility in the message, we may continue to send commercial electronic messages to those addresses. Consent By signing this Statement you agree to its terms Name Name Applicant Guarantor Account Signatory Authorised Representative of Corporate Applicant Corporate Guarantor Applicant Guarantor Account Signatory Authorised Representative of Corporate Applicant Corporate Guarantor Page 9 of 18 BWA-F (LF19.LF20.F196.F222)

10 Required Comments Background details Business history Nature of business and industry Management structure of business, and corporate and trust structure Key personnel and experience Staffing levels Code of Banking Practice Is Deal Code of Banking compliant? (i.e. less than 20 full-time employees or less than 100 full-time employees for manufacturing business) Yes No List new third party guarantors List director/guarantors requiring Borrower Information Pack Proposal What are we funding? Why are we funding? Cover deposit paid? Yes No Customer s settlement contribution? Security details cover Full address of security Type of security? Residential Commercial of security owners s of all guarantors, beneficiaries and shareholders (for guarantee purposes) Page 10 of 18 BWA-F (LF19.LF20.F196.F222)

11 Disclosure Statement To: Applicant name ABN Address In terms of our Financial Services Organisation Agreement ( Agreement ) with Bankwest, we are required to disclose the facts set out below at the commencement of discussions with you regarding a possible application to the Bank for financial accommodation. As evidence of our disclosure, kindly sign this Disclosure Statement and return it to us. Signing this statement does not commit you to proceed with an application to the Bank; it merely confirms our having informed you of the matters referred to in this Disclosure Statement, and your consent to them. 1. We provide origination services to the Bank pursuant to the Agreement. 2. As such, we will be entitled to make enquiries about your credit history and credit capacity, and pass that information to the Bank. 3. As we provide services to you and the Bank and the Bank will pay us commission, it is likely that we will be in a position where conflict of interest could arise. By signing this Disclosure Statement, you acknowledge that fact and you give your consent to our acting in this way. We will, of course, maintain the highest professional standards in representing the different interests of you and the Bank, and we will always place our own interests last. 4. We will submit information regarding you (and your business) to the Bank. This may include information which you have given to us in confidence as your adviser. We will provide a copy to you before disclosing information to the Bank. You may instruct us not to disclose that information and we will then decide whether or not we wish to proceed with the application. 5. You consent to the Bank disclosing to us the fate of any application we submit on your behalf and providing us with a copy of the bank s approval terms and conditions. 6. In our relationship with the Bank, we enjoy some or all of the following benefits: discount banking services commission (including trailing commission). 7. If the Bank pays us a trailing commission you consent to the Bank disclosing to us information about the facility on an ongoing basis so that we can check the amount of commission received. If you have any queries about the content of this Disclosure Statement, please discuss them with us prior to signing. Yours faithfully, Partner/Principal/Director (loan introducer) Acknowledgement and approval We acknowledge receipt of the information contained in this Disclosure Statement and consent to its terms. In respect to any application for a financial service I/we declare that all particulars provided by me/us will be true and correct and that I/we will not withhold any information which may affect the Bank s decision. of Applicant(s) or On behalf of the Applicant (in his/her/their capacity as, for and on behalf of the Applicant, being duly authorised). Page 11 of 18 BWA-F (LF19.LF20.F196.F222)

12 Customer Identification Original documents must be sighted Section A (Complete this section only if copies of documents are forwarded to Bank) Types of identification Photographic identification (Please provide one of the following) Family name 1 Family name 1 Australian Passport (Current or under two years expired) Current foreign passport Current Australian Driver s Licence with photo Proof of Age card issued under law of an Australian state or territory Collected Collected OR Non-photographic primary identification (Please provide one of the following) Australian Birth Certificate or Extract Foreign birth certificate Australian Citizenship Certificate Collected Collected AND Non-photographic secondary identification (Please provide one of the following) Rating authority (e.g. Shire) bill sighted (under 12 months old) Public Utility Records bill sighted (under three months old) Australian Taxation Office notice (under 12 months old) Collected Collected Section B (Complete this section if copies of documents are not being forwarded to Bank) Sight original documents only not copies. All documents must be in the current name of the Applicant. Photographic identification Family name 1 Family name 2 Document type Name as appears on document Document issued by Document number of issue Expiry date Photo or signature on identification Yes No Yes No of birth (if shown, does DOB match?) Yes Not shown Yes Not shown Does residential address match (if shown)? Yes Not shown Yes Not shown OR Non-photographic primary identification Document type Name as appears on document Document issued by Document number of issue Expiry date Photo or signature on identification Yes No Yes No of birth (if shown, does DOB match?) Yes Not shown Yes Not shown Does residential address match (if shown)? Yes Not shown Yes Not shown PLUS Non-photographic secondary identification Document type Name as appears on document Document issued by Document number of issue Expiry date Photo or signature on identification Yes No Yes No of birth (if shown, does DOB match?) Yes Not shown Yes Not shown Does residential address match (if shown)? Yes Not shown Yes Not shown Page 12 of 18 BWA-F (LF19.LF20.F196.F222)

13 Bank/Broker use only Results of check Has verification been achieved? Yes No Name of checking officer Staff/Broker number Page 13 of 18 BWA-F (LF19.LF20.F196.F222)

14 BRGS Non-financial Information Mandatory for all deals Please grade the following 4 questions by selecting a score between 5 and -5 Customer and supplier relationship 5 4 Customers dependent on company (monopoly or oligopoly in market). Very close ties with customer and many stable suppliers Limited competition for customer (over 25% market share) and strong bargaining power over suppliers 3 Few competitors with limited supplier concentration 2 1 Well developed relationships to loyal customers and stable suppliers, though competition at a moderate level Well developed relationships to loyal customers and stable suppliers, though competition at a high level 0 Not over reliant on customers and/or suppliers -1-2 Customers marginally have the balance of power in determining prices, though supplier relationship is strong Customers have the balance of power in determining prices,though supplier relationship is strong -3 Some reliance upon major suppliers and/or customers -4-5 Moderate reliance upon major suppliers and customers have the balance of power in determining price Dependent upon one or a few suppliers and/or customers Industry standing 5 Market leader, constantly selling market standards Strong player positioned in the top 5% of competitors in relation to market share Strong player positioned in the top 20% of competitors in relation to market share Well positioned second tier players, though at some risk of losing position 1 Considered to be marginally above industry average Positioned neutrally within the industry, with equal proportions of more and less established competitors Less market share than the industry average player, but with potential to improve Less market share than the industry average player, with limited potential to improve Minimal market share with no great competitive advantage Minimal market share and poor reputation within industry Disadvantaged player held in very poor regard by peers Outlook Internal experience of company Very strong business with good outlook, expected to exceed forecast for next 12 months Strong business with a positive outlook, results are expected to be in line with forecasts Outlook more positive than historic figures/ performance suggests Current indications suggest a slightly improved performance relative to historic figures/performance Expectations of a slightly improved performance relative to historic figures/performance Outlook stable. Prospects reasonable. No significant structural/operational changes anticipated Outlook stable. Prospects reasonable. Restructuring may improve prospects -2 Outlook stable. Prospects not favourable Outlook less positive than historic figures suggest. -3 Restructuring and/or operational support needed Outlook and prospects poor and requires -4 operational support Outlook and prospects very poor. Company -5 unlikely to survive without major structural and/or operational changes Mature customer, good financial record and clean covenant history 5 10 years with Bank, with a consistently good financial record and clean covenant history Customer between 2 and 5 years with Bank good financial record and clean covenant history Mature customer good financial record, though has had minor covenant breach Mature customer generally good financial record, though has had minor covenant breach New customer to Bank or customer has breached covenants in the past New customer to Bank or customer has breached covenants in the past or has experienced a period of financial deterioration (though always profitable) New customer to Bank or customer has breached covenants in the past and has experienced a period of declining profits (though not loss) -3 Customer has been in arrears in the past 12 months -4 Customer has been in default in the past -5 Customer has incurred a loss for the Bank in the past Page 14 of 18 BWA-F (LF19.LF20.F196.F222)

15 Direct Debit Request Bank copy Section 1 Customer details New Existing Cancel existing instructions? Yes No I/We authorise and request (User ID No. 473, 954 or ) until further notice in writing, to arrange for my/our account (as described in Section 2 below) to be debited as specified. If no amount is specified, the account may be debited with any amount(s) Bankwest feels appropriate. Given name(s) Given name(s) Company name (if applicable) ACN (if applicable) Address(es) Section 2 The Schedule State State Postcode Postcode Note: Direct Debiting is not available on the full range of accounts. If in doubt, please refer to your financial institution. Please ensure account details are correct and that this request is signed by required number of authorised signatories Debit account details Financial institution Branch Account name(s) BSB Account number Amount (do not complete if amount will vary) Payment details Direct debit commencement date Frequency Weekly Fortnightly 4 Weekly Monthly Quarterly Annually Upon request Additional options for loans only Debit credit card Account number Credit Bankwest account BSB Account number Interest only Standard monthly repayment Fixed amount Account balance Statement balance Minimum payment due Section 3 Declaration Upon receipt of my/our telephone, electronic or written instructions from time to time, please debit my/our account at the institution referred to above, with the amount referred to in the instructions, and credit the amount to my/our account with you, as I/we specify. You determine the order of priority of payments under this arrangement and other authorities or mandates I/we have given you. For instructions given by telephone or electronic means: I/we acknowledge that use of these services involves a greater risk of unauthorised use of my/or nominated account. I/we must safeguard the security of all passwords and security codes and not disclose them to anyone. I/we understand that they are the equivalent of my/our Processing staff member BB signature on a transaction. I/we accept full responsibility for any loss, claim or damages which you may suffer as a result of acting upon instructions you receive which include my/our passwords or security codes. I/We have read the Service Agreement overleaf and agree to its terms. You may continue to rely on this request until you receive my/our written notice to the contrary. I/we will notify you in writing if a change is required to the nominated account. If the method of operation of the nominated account requires more than one signature, then this request must be signed in the same manner. Page 15 of 18 BWA-F (LF19.LF20.F196.F222)

16 Section 4 Direct debit request service agreement 1. as Debit User will initiate direct debit payments in the manner referred to in the Schedule. 2. Debit payments will be made when due. Bankwest will not issue individual confirmation of payments made. 3. Bankwest will give the customer at least 14 days written notice if Bankwest proposes to vary details of this arrangement, including the amount and frequency of payments. 4. If the customer wishes to defer any payment or alter any of the details referred to in the Schedule, the customer must either visit a Bankwest Customer Service Centre, telephone the Business Customer Support Team on or write to Bankwest at the following address: Transactional Banking Unit Level James Street Northbridge WA Any queries concerning debit payments or disputed debit payments must be directed to Bankwest as Debit User in the first instance. Customers may obtain details of the claims process by contacting the Business Customer Support Team on Direct debiting is not available on the full range of accounts at all financial institutions. If in doubt, the customer should check with the financial institution before completing this Direct Debit Request. 7. The customer should ensure that the account details given in the Schedule are correct by checking them against a recent statement from the financial institution at which the account is held. 8. By signing this Direct Debit Request, the customer warrants and represents that he/she/they is/are duly authorised to request the debiting of payments from the account described in the Schedule. 9. It is the customer s responsibility to have sufficient cleared funds available in the account to be debited to enable debit payments to be made in accordance with this Direct Debit Request. 10. If a debit payment falls due on any day which is not a business day, the payment will be made on the next business day. 11. If a debit payment is returned unpaid, Bankwest may charge the customer a fee for each unpaid item. 12. Customers wishing to cancel this Direct Debit Request or to stop individual debit payments must give at least 7 days written notice to the Bankwest Transactional Banking Unit. This may be arranged at a Bankwest Customer Service Centre or by calling the Business Customer Support Team on Except where the account or banking service terms and conditions permit disclosure, and except to the extent that disclosure is necessary in order to process debit payments, investigate and resolve disputed transactions or is otherwise required or permitted by law, Bankwest will keep details of the customer s account and debit payments confidential. Page 16 of 18 BWA-F (LF19.LF20.F196.F222)

17 Identity Declaration Australian Proprietary or Foreign Registered Company Important Information The information contained in this Declaration is sought pursuant to the Anti-Money Laundering and Counter-Terrorism Financing Act Please complete using BLOCK letters. Complete the following if you are one of the following companies (Public companies do not need to fill in this form). Please tick ( ) where applicable Australian Proprietary (Pty Ltd) Section 1 General company information of company Foreign Registered Country of incorporation Country where primary operations are conducted ACN or ARBN If Foreign Registered Name of foreign registration authority Foreign registration number Section 2 Ownership details Provide details of all Beneficial Owners. These are individuals who own through one or more (direct or indirect) shareholdings of more than 25% of the company s issued capital. Beneficial owner 1 Full given name(s) Full residential address (PO Box is not acceptable) State Postcode Country Beneficial owner 2 Full given name(s) Full residential address (PO Box is not acceptable) State Postcode Country Beneficial owner 3 Full given name(s) Full residential address (PO Box is not acceptable) State Postcode Country Beneficial owner 4 Full given name(s) Full residential address (PO Box is not acceptable) State Postcode Country Page 17 of 18 BWA-F (LF19.LF20.F196.F222)

18 Section 3 Director details Provide details of all Company Directors not already listed as a Signatory. Where the Company has more than 4 Directors, please supply these details on a separate sheet and attach to this Declaration. Director 1 Full given name(s) Full residential address (PO Box is not acceptable) of birth (optional) Director 2 Full given name(s) State Postcode Country Full residential address (PO Box is not acceptable) of birth (optional) Director 3 Full given name(s) State Postcode Country Full residential address (PO Box is not acceptable) of birth (optional) Director 4 Full given name(s) State Postcode Country Full residential address (PO Box is not acceptable) of birth (optional) State Postcode Country This statement explains how Bankwest (we/us/our) collects, uses and discloses personal information and provides your consent for us to send communications about products and services. Personal information is information about and which identifies an individual, including information about credit worthiness, standing, history and capacity. When you give us personal information about another person, you represent that you are authorised to do so and agree to inform that person who we are, that we will use and disclose that information for the relevant purposes set out below and that they can access the information we hold about them. Purposes for which we collect and use personal information You agree that personal information about you provided to us at any time in connection with this account may be held and used by us to process the application, establish, provide and administer the account and execute your instructions and, as relevant, comply with legislative/regulatory requirements, consider other applications you make, perform administrative tasks including systems development, testing, credit scoring and training, manage our rights/ obligations regarding external payment 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. membership of a professional or trade association). We are required by law to collect information to identify and verify you. Also, without your information, we may not be able to provide a facility. Disclosure of personal information You agree we may disclose personal information about you to the following, 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, beneficiary if you are a trustee, guardian or attorney, law enforcement, regulatory and government bodies, anyone who introduces you to us, 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 Unless you ask us, by calling , 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. Receiving commercial electronic messages You consent to us sending commercial electronic messages (including messages about our products and services and the products and services of any third party) to any electronic address which you provide or for which you are responsible. You warrant that you have authority, either as or on behalf of the electronic account holder, to provide this consent and agree that until you withdraw your consent by providing written notice to us or using an unsubscribe facility in the message, we may continue to send commercial electronic messages to those addresses. Section 4 Declaration This declaration is to be signed by a director, secretary or other able to evidence that they are authorised to act on behalf of the company. I understand and acknowledge that Australian 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 or documents in connection with the provision of financial services and the making, possession or use of a false document in connection with an identification procedure. I declare that the details as shown on this form are complete and correct. Position Page 18 of 18 BWA-F (LF19.LF20.F196.F222)