Credit File Assessment Application Agreement between Credit Mend Australia Pty Ltd.ACN 643 405 707 & Is this application being made in a company name? YesNo Name of Company ACN Number Are you currently employed?* YesNoSelf Employed Name of Current Employer* Please Provide Name of Your Business* Consultants Name* First Name* Middle Name Surname* Phone Mobile* Phone Work Email Address* Confirm Email Address* Date of Birth* - - - Select Date - - -01020304050607080910111213141516171819202122232425262728293031 - - - Select Month - - -JanFebMarAprMayJunJulAugSepOctNovDec - - - Select Year - - -194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002 Confirm Date of Birth* - - - Confirm Date - - -01020304050607080910111213141516171819202122232425262728293031 - - - Confirm Month - - -JanFebMarAprMayJunJulAugSepOctNovDec - - - Confirm Year - - -194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002 Gender* MaleFemale Current Residential Address* - - - Select State - - -QLDWASAVICTASNTNSWACT Have you been at this address less than 3 years? YesNo Previous Residential Address* - - - Select State - - -QLDWASAVICTASNTNSWACT Have you used a credit repair agency before?* YesNo Name of Institution* Please provide name of the consultant you were dealing with* Do you currently hold a drivers licence?* YesNo Drivers Licence* Passport Number* Are you currently bankrupt or in a Part 9/10 debt agreement?* YesNo Terms and Conditions* Credit Mend Australia Pty Ltd.Terms & Conditions By completing your online signature you are agreeing to the terms and conditions on this page and understand this is the same as an original signature and is binding. Term And Conditions Credit Mend Australia will use its best endeavors to improve and amend your records of creditworthiness with the relevant credit reporting body subject to the following terms and conditions. The customer repays and consents to keep repaid the supplier against any misfortune, cost and costs, activity or claim emerging however out of this agreement, spare and with the exception of activities and cases emerging from the supplier's practice of due care and expertise, in giving the administrations. You unavoidably and unequivocally approve Credit Mend Australia to contact, and liaise with, all creditors that Credit Mend Australia and any of its representatives deem necessary, all credit reporting organizations to get your records of creditworthiness by method for phone, email, web access, copy or in any case that Credit Mend Australia sees fit. The customer warrants that the information the customer gives to the supplier is valid and correct. The services carried out by Credit Mend Australia exclude any financial and legal related services. You confirm your understanding that Credit Mend Australia makes no representation or guarantee of redressing or changing your records of creditworthiness with any organization or reporting body or in getting loan approval or financial funding howsoever. The parties concur that this arrangement contains the greater part of the terms and conditions as concurred by the parties and there are no other security agreements, understandings or plans. You recognizes that: - You have not depended on any representation or actuations provided by Credit Mend Australia; and You have had the chance to get legal and financial related advice and either:- Acknowledges that advice and consents to this arrangement appropriately; or Waives the privilege to get that advice and consents to this arrangement as needs be. You acknowledge and agree: Credit Mend Australia makes no assurance for improving or changing your records of creditworthiness with any credit reporting body as a result of our investigation. Credit Mend’s standard “admin fee” for its investigation service is $499 inc GST. This fee is payable upon authorizing Credit Mend Australia to proceed with the investigation and attempt to remove the “negative listing”, “default”, “writ”, “summons”, “Court Judgment”, “serious Credit infringement” and this “admin fee” is non-refundable. The “admin fee” of $499 inc GST is a fee payable for Credit Mend Australia to conduct an investigation and attempt to get the “negative listing” removed. The term and any reference to “negative listings” only includes consumer & commercial defaults, court judgement, clear-outs or serious credit infringements, summons and court writs removed, and does not guarantee the removal only the attempt to try and remove. The “removal fee” of $654.50 inc GST is payable upon “written confirmation to be removed ” of the “negative listing”, “default”, “writ”, “summons”, “serious credit infringement” upon receiving written confirmation from the creditor. The “removal fee” of $1,644.50 inc GST for Court Judgments is only payable upon “written confirmation to be removed ”or “Plaintiff” that they will remove. You as the “client” agree and are liable to pay the “removal fee” once the written confirmation is received from the Plaintiff and is payable upon receiving this confirmation in writing. Should the creditor not provide written confirmation of the removal then the “removal fee” fee is not payable and no other “fee’s” and or “charges” are payable to Credit Mend Australia. Should you not follow the agreement and arrangement agreed upon within the disclosed resolution agreement and or requirements outlines by the “Debt collector” “Creditor” “Plaintiff” “Debtor” made between the parties involved, being you the client and or the “Creditor”, “Debt collector” or “Plaintiff” and do not honour your obligations as outlined to you, in relation to any debts rightfully owed and payable. You are then in breach of the removal agreement and Credit Mend Australia are not liable should the bad credit listing, being that of either a “Default” “Judgment” “Serious credit infringement” “Clear-out” “Writ” or “Summons” not be removed, due to you not honoring the debt rightfully owed and payable should that be the case. The client acknowledges that the Credit Mend Australia makes no representation or promise of rectifying or changing the client’s records of creditworthiness with any agency or credit reporting body or in obtaining finance. Authorisation of Authority to Credit Mend Australia: By making an application to Credit Mend Australia you agree to give authority to us to access your consumer and commercial credit information held by a Credit Reporting body on your behalf. The authority you give us includes helping you in dealing with a credit reporting body or credit provider in relation to the services you have sought from us. When we access your file, it is as an access seeker. Your information may be disclosed to third parties if it forms part of the service offered to you. The Authorisation of Authority to Credit Mend Australia for approached credit provider(s) and or Plaintiff to collect & disclose credit information about applicant(s)/Guarantor(s) By making an application to Credit Mend Australia and or initial inquiry made by you and or us/we, You acknowledge and consent to Approach Credit Provider(s) and or Plaintiff, subject to the Commonwealth Privacy Act, collecting, using and disclosing Credit Information [as defined below in section d] if necessary The Information may also be collected from and disclosed to others to achieve the purpose As disclosed by you in your initial enquiry to ensure your initial enquiry is satisfied in its entirety. The Authorisation of Authority to Credit Mend Australia applicant(s) & / or guarantor(s) for introducer/broker & approached credit providers to handle personal information. The Information may be collected from me/us, The Information may also be collected from and disclosed to others to achieve the purpose by You and/or the Approached Credit Provider. You and the Approached Credit Provider(s) will collect, use and disclose information about me/us that identifies me/us or from which my/our identity can be reasonably ascertained (the Information). The Information may include my/our identity details, financial details and employment details. It may also include “sensitive information” (eg health information, membership of professional/trade associations) in relevant circumstances and I/we consent to its collection. The authorisation of Authority for Governing departments including, but not limited to, the (ATO, ASIC, AFCA) Only information necessary to you for external complaints resolution purposes & or as required to by law. Only Information necessary for You or the Approached Credit Provider(s). Government departments (including, but not limited to, the ATO, ASIC, AFCA Registrars of business names, land/other assets, births deaths marriages, drivers licence). Only Information necessary for You and the Approached Credit Providers will not otherwise use or disclose the Information for any other purpose without consulting me/us before doing so in accordance to the law. By providing your contact information to us, you authorise Credit Mend Australia to make contact with you by email or by phone call or any other way of corresponding with you that you have willingly and knowingly provided to us; You are over the age of 18 years; Payment for the removal of a negative listing is required irrespective of whether you chose to terminate this agreement prior to the negative listing being removed. You acknowledge that Credit Mend Australia undertakes the services upon agreement of these terms and conditions. Therefore, the removal fee becomes due and payable on the date the confirmation of removal is received in writing by the debt collector, creditor, plaintiff. This agreement will be terminated and you will not be eligible for a full or partial refund if you do not respond to Credit Mend Australia’s attempts to contact you via phone calls, SMS or letters for greater than 30 days: or as per the resolution agreement and or requests from the associated debt collector, creditor, plaintiff. Signature* Date* By ticking this box you are here by accepting the above terms and conditions on this agreement page and understand that this signature acts as a normal signature and is legally binding.* Your details are kept confidential By completing your online signature you are agreeing to the terms and conditions on this page and understand this is the same as an original signature and is binding.