FINANCE APPLICATION NOVATED LEASE - …

1 ABN 56 103 618 499 Address 3/3 Rocklea Dr, Port Melbourne, VIC 3207 Postal PO Box 183, South Melbourne, VIC 3205 Email Website Phone 1300 132 500 Fax 1300 500 150 Southgate Salary Packaging Services 2017 FINANCE APPLICATION NOVATED LEASEPERSONAL DETAILS Title Given Name Surname Middle Name/s Maiden Name Date of Birth Driver s Licence No. Expiry Driver s Licence Type Full Provisional Learner Heavy Vehicle None Marital Status Single Married De Facto / Partner No. of Dependants Residency Citizen Permanent Resident VISA (Specify Type) _____ Residential Address Suburb State Postcode Postal Address Suburb State Postcode Home Phone Work Phone Fax Mobile Phone Email HOME OWNERSHIP STATUS (Minimum total of 3 years Residential History required) Current Status Own Outright Mortgaged Renting Boarding Living with Relatives Years at Address Months at Address Landlord s Name & Phone (if renting)

2 Previous Address Years At Address Suburb State Postcode CURRENT EMPLOYER DETAILS Current Employer ABN Position Years with Employer Months with Employer Employer s Address Suburb State Postcode Contact Name Position Phone Employment Status Full Time Part Time Casual Contract Category Office/Clerical Professional Trade Unskilled PREVIOUS EMPLOYER DETAILS (If current employer is less than 3 years) Previous Employer ABN Position Years with Employer Months with Employer Employer s Address Suburb State Postcode Contact Name Position Phone Southgate Salary Packaging Services 2017 STATEMENT OF ASSETS AND LIABILITIES ASSETS Own Outright?

3 (if not owned outright, ensure related liability is listed under Liabilities) Home Property $ _____ Yes No Investment Property 1 $ _____ Yes No Investment Property 2 $ _____ Yes No Investment Property 3 $ _____ Yes No Shares/Trust/Managed Funds $ _____ Yes No Recreational Assets (Boat/RV) $ _____ Yes No Plant & Equipment $ _____ Yes No Motor Vehicle 1 $ _____ Yes No Motor Vehicle 2 $ _____ Yes No Cash in Bank $ _____ Superannuation $ _____ Home Contents $ _____ LIABILITIES Current Balance Monthly Payment Bank / Institution Home Property $_____ $_____ Investment Property 1 $_____ $_____ Investment Property 2 $_____ $_____ Investment Property 3 $_____ $_____ Margin Loan $_____ $_____ Loan for Investments $_____ $_____ Personal Loan $_____ $_____ Recreational Asset Loan $_____ $_____ Plant & Equipment Loan $_____ $_____

4 Motor Vehicle 1 Loan $_____ $_____ Motor Vehicle 2 Loan $_____ $_____ LIABILITIES CONT. Current Balance Owing Monthly Payment Bank / Institution Credit Limit Credit Card 1 $_____ $_____ $_____ Credit Card 2 $_____ $_____ $_____ Credit Card 3 $_____ $_____ $_____ Bank Overdraft/s $_____ $_____ $_____ Debt Agreement $_____ $_____ Tax Debt $_____ $_____ STATEMENT OF MONTHLY INCOME AND EXPENSES MONTHLY INCOME MONTHLY EXPENSES Gross Monthly Income $ _____ Mortgage Repayment $ _____ Net Monthly Income $ _____ Rent or Board $ _____ Spouse/Partner Gross Income $ _____ Vehicle Running Costs $ _____ Spouse/Partner Net Income $ _____ Private Education/Childcare $

5 _____ Investment Property Income $ _____ Rental Property Expenses $ _____ Government Benefit Income $ _____ Other Expenses $ _____ Superannuation Income $ _____ General Living Expenses* $ _____ Investment Income $ _____ *(household/living food, phone, utilities, council rates, discretionary purchases) Other Income $ _____ Southgate Salary Packaging Services 2017 INSURANCE OPTIONS (These can be included in your financed amount) Would you like Southgate to provide a quotation including: LEASE Protection Insurance LEASE Protection Insurance is designed to give you peace of mind by giving you the option to dispose of your LEASE vehicle or receive assistance with LEASE payment obligations when certain unforseen events occur in your life.

6 This policy covers a range of specific circumstances outlined in the PDS, including involuntary unemployment, specified illness and physical disability. Included is an Additional Monthly Payment Option to help you cover your LEASE payment obligations to the financier if you choose to keep your LEASE vehicle. Yes No GAP Insurance (Equity Insurance) GAP Insurance is designed to cover any shortfall you may be required to pay your financier where your asset is stolen or written off and the Total Loss Payment made by your comprehensive insurer is insufficient to pay out the balance of your LEASE agreement.

7 Yes No DECLARATION & SIGNATURE I declare have read and understood the particulars that have been completed in this declaration and state that those particulars are true, complete and not misleading, and have been made to Southgate Salary Packaging Services and the financier to enable us to assess my FINANCE APPLICATION . Name Signature Date CHECKLIST - Items to be returned with FINANCE APPLICATION Required Items to be returned with your FINANCE APPLICATION : Signed Privacy Form Photocopy of Driver s Licence 2 x Recent Payslips OR Letter of Employment Please return your documents via: Fax: 1300 500 150 Email: or email directly to your Southgate consultant.

8 Post: PO Box 183, South Melbourne VIC 3205 APPLICATION for Credit Privacy Consents/Acknowledgments (Version ) Privacy Act 1988 (Cth) and all related rules and regulations ( Act ) To: Macquarie Leasing Pty Limited ABN 38 002 674 982 ( You ) I acknowledge that You may collect, hold, use and disclose personal information about me (including information required to comply with Anti-Money Laundering and Counter-Terrorism Financing Act 2006, rules and other subordinate instruments, the National Consumer Credit Protection Act 2009 and the Personal Property Securities Act 2009) to enable You to: assess my personal and/or commercial credit worthiness; process my APPLICATION ; provide, administer and manage the products and services provided to me.

9 Audit and evaluate those products and services; notify a credit reporting body or other credit providers of my payment history or any default by me; model and test data; communicate with me; improve and develop products and services; conduct credit scoring, securitisation, research, risk management and portfolio analysis; provide and administer any related rewards program and deal with any complaints or enquiries. I acknowledge that if I fail to provide complete information or information that is inaccurate, You may not be able to process or accept the APPLICATION and transactions may be delayed, blocked or refused.

10 Authority for You to obtain certain credit information: I authorise You, Your agents and third parties who referred me to You to seek, obtain and use, credit reporting information about me (including from credit reporting bodies ( CRBs )) to: assess an APPLICATION by me for consumer credit or commercial credit; manage my credit and related funding arrangements; assess an APPLICATION by me to be a guarantor in relation to credit; review my credit on a periodic basis as though assessing a new APPLICATION ; collect overdue payments; and create assessments and ratings of my credit worthiness.