Fillable ANZ Business Credit Application Form (Australian National University)

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ANZ Business Credit Application Form (Australian National University)

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ANZ Business Credit Application Form
Page 1 of 8
120343
Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522. Australian Credit Licence Number 234527.
Information Classification: Confidential
Please complete this application and return it together with the
information requested below to your nearest ANZ Business Centre or
Branch. If you already have a relationship with ANZ you may not have
to complete all sections. Please contact your ANZ Business Centre or
Branch Manager to confirm.
Completion of this form does not ensure the approval of your credit
application. You should complete all sections of the application to
provide the information we will require to undertake our assessment
Please attach the following documents
Please attach signed copies of the following documents, as directed by,
your ANZ Business Centre or Branch Manager, for all applicants,
directors, proprietors and guarantors (as applicable):
• Signedbalancesheetsandprofitandlossstatements(1or2years
as appropriate)
• Personaltaxreturns(1or2yearsasappropriate)
• Signedpersonalstatementoffinancialposition.
If you have been operating in your industry for less than three years,
please also include copies of your:
• Cashflowforecastforthenext12months
• Businessplan
• Industryqualitycertificationoraward(ifapplicable).
Other documentation
Last 6 months bank statements should be attached if you are not
currently an ANZ customer.
Copies of any asset valuations and insurance certificates.
Certificate of Incorporation for a company (including Memorandum
and Articles of Association) or Registration of Business Name for a firm.
Copies of trust deeds if borrower or guarantors operate as a trust.
BORROWER/APPLICANT DETAILS
Borrower’s name in full
Type of business entity
SoleProprietor Partnership Public Company Trustee Company Association Pty Ltd Other
ABN or ACN Registered business name (if applicable)
Business Trading Address and Contact Details
Street Suburb State Postcode
BusinessPhone Fax
Email
Business Postal Address (leave blank if same as above)
Street/POBox Suburb State Postcode
BUSINESS DETAILS
Briefly describe your business
Type of industry
Yearsofmanagementexperienceofdirector/keydecisionmaker? Datecommencedtrading(undercurrentownership)
Who are the proprietors/partners/directors/shareholders/beneficiaries?
Name Shares/%Owned Position
1.
2.
3.
4.
Use this application form for Business and/or Agricultural Borrowers with total ANZ credit requests up to and including $1 million.
ANZ Business Credit Application Form
Page2of8
120343
Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522. Australian Credit Licence Number 234527.
Information Classification: Confidential
Hasyourbusinessdiversified? Yes No If Yes when
Number of employees Number of legal entities in-group Number of legal entities with ANZ
Number of years with
current bank Bank Branch
BSB&Accountnumber(onlyapplicableifanANZaccount)
BSB Accountnumber
dOes yOur Business currently
Operate as a franchise
No Yes/details
Domorethan25%ofitsbusinesswithonecustomer No Yes/details
Domorethan25%ofitsbusinesswithonesupplier No Yes/details
Import/export No Yes/details
Leaseofficeequipment/plant/motorvehicles No Yes/details
Holdlife/incomereplacement/businessinsurance No Yes/details
Have a business superannuation plan No Yes/details
Invest in property (other than that which it operates in) No Yes/details
UseMerchant/EFTPOSfacilities No Yes/details
Have a payroll service No Yes/details
Use internet or telephone banking No Yes/details
Use business credit cards No Yes/details
Have any other financial service No Yes/details
PersOnAl detAils
Name in full
Director Partner SoleProprietor Guarantor
Residential Address
Suburb State Postcode
Time at current address
Years Months
DriversLicenceNumber StateofIssue
DateofBirth Gender
Male Female
AreyouapermanentAustralianresident?
Yes No
Marital status No. of dependants
Name in full
Director Partner SoleProprietor Guarantor
Residential Address
Suburb State Postcode
Time at current address
Years Months
DriversLicenceNumber StateofIssue
DateofBirth Gender
Male Female
AreyouapermanentAustralianresident?
Yes No
Marital status No. of dependants
ANZ Business Credit Application Form
Page 3 of 8
120343
Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522. Australian Credit Licence Number 234527.
Information Classification: Confidential
PersOnAl detAils (cOnt.)
Home Phone Work Phone
Fax Mobile
Email
Home Phone Work Phone
Fax Mobile
Email
Home Phone Work Phone
Fax Mobile
Email
Home Phone Work Phone
Fax Mobile
Email
PersOnAl detAils PersOnAl detAils
Name in full
Director Partner SoleProprietor Guarantor
Residential Address
Suburb State Postcode
Time at current address
Years Months
DriversLicenceNumber StateofIssue
DateofBirth Gender
Male Female
AreyouapermanentAustralianresident?
Yes No
Marital status No. of dependants
Name in full
Director Partner SoleProprietor Guarantor
Residential Address
Suburb State Postcode
Time at current address
Years Months
DriversLicenceNumber StateofIssue
DateofBirth Gender
Male Female
AreyouapermanentAustralianresident?
Yes No
Marital status No. of dependants
ANZ Business Credit Application Form
Page 4 of 8
120343
Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522. Australian Credit Licence Number 234527.
Information Classification: Confidential
Inthepast12monthshasachequeissuedbyyou/yourbusinessbeen Yes No
dishonoredduetoalackoffunds?
Hastheborrowingentityhadproblemswithanyotherbank/creditor
Yes No
overthelast12months?
Haveanytaxationoutstandingbeyondcurrentarrangements?
Yes No
Istheprincipleplaceofbusinesssubjecttolease?
No Yes/details
IfYes,brieflysummarisetermandexpirydate
KEY CONTACTS ANZ MAY CONTACT THESE PEOPLE TO CONFIRM DETAILS WHICH RELATE TO THIS APPLICATION
Accountant Financial Controller
Name Name of firm
Telephone Fax Email
Solicitor Financial Planner
Name Name of firm
Telephone Fax Email
FINANCIAL PERFORMANCE SUMMARY ALL BORROWERS
Business Trading Results
Year ended
Revenue
$
Interest/Lease* 
$
Depreciation 
$
NetProfitbeforetax 
$
Taxexpense 
$
Dividends/Drawings 
$
Number of trading losses from the two
mostrecentfinancialyears?
*Includeinterestpaidonleasefinance&HPcontract
Year ended
Revenue
$
Interest/Lease* 
$
Depreciation 
$
NetProfitbeforetax 
$
Taxexpense 
$
Dividends/Drawings 
$
Number of trading losses from the two
mostrecentfinancialyears?
*Includeinterestpaidonleasefinance&HPcontract
ANZ Business Credit Application Form
Page5of8
120343
Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522. Australian Credit Licence Number 234527.
Information Classification: Confidential
EXISTING AND REQUESTED BUSINESS FACILITIES
ANZ and Non-ANZ business loan/facility details (including lease finance and HP contracts)
Facility Secured Expirydate Repaymentamount/ Finance ExistingLoan/ Loan/limitamount
Y/N frequency(e.g.$100/P.M) provider limitamount requested
1.
$ /
$
$
2.
$ /
$
$
3.
$ /
$
$
4.
$ /
$
$
5.
$ /
$
$
6.
$ /
$
$
Total Proposed ANZ and Non-ANZ business loan limits
$
$
SECURITY
Security to be offered in support of this business application (include security to be offered in respect of loans to be refinanced by ANZ)
DetailsofSecurity(eg.propertyaddress) Givenby(owner) Estimatedvalue Ifunderfinance,nameofprovider
1.
$
2.
$
3.
$
4.
$
Security held by other finance providers in support of existing non-ANZ business loans listed above
(excludesecuritytobeofferedinrespectofloanstoberefinancedbyANZ)
DetailsofSecurity(eg.propertyaddress) Givenby(owner) Estimatedvalue Ifunderfinance,nameofprovider
1.
$
2.
$
3.
$
4.
$
ANZ Business Credit Application Form
Page 6 of 8
120343
Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522. Australian Credit Licence Number 234527.
Information Classification: Confidential
PERSONAL STATEMENT OF FINANCIAL POSITION 1
Astatementofpositionmustbecompletedby:-Eachapplicant(ifindividual)-EachDirector/Partner/soleproprietor(ifapplicantisacompany,
partnership or business)- Intending guarantors
Name (s)
As at
ASSETS Present value
Bank account
$
Property - primary residence
Location:
$
Property - other
Location:
$
Location:
$
Location:
$
Motorvehicles(make/model) 
$
Make/model
$
Make/model
$
Make/model
$
Furniture/householdgoods
$
Superannuation
$
Held with:
Shares 
$
Personal equity in any private business
$
Life insurance
$
Held with:
Other assets
$
Please specify:
Total Assets (1)
$
LIABILITIES
Loan Current outstanding
Personal Overdraft(s)
Limit(s) ANZ
$
$
Personal Overdraft(s)
Limit(s) Non-ANZ
$
$
Mortgage Loan(s) ANZ
$
Mortgage Loan(s) Non-ANZ
$
Other loan(s) ANZ
$
Other loan(s) Non-ANZ
$
Credit/Deptstore
card(s) Limit(s)
$
$
Other liabilities
Outstandingtaxationdue
//
$
Other
$
Please specify:
Other
$
Please specify:
Total Liabilities (2)
$
INCOME AVERAGE MONTHLY
Base salary gross (p.m.) Net (p.m.)
Income earner 1
$
$
Incomeearner2
$
$
Other income Net
Regular overtime
$
Part-time/casualemployment
$
Dividends/Interest
$
Commission
$
Rent received
$
Annual gross
$
x75%*
$
*Donotshowrentalpropertyexpensesasaseparateexpenseitem
Other income
$
Please specify:
Other income
$
Please specify:
Total net monthly income (3)
$
EXPENDITURE AVERAGE MONTHLY
Credit commitments
Housing loan repayments
$
Other loan repayments
$
Financelease/hirepurchaserepayments 
$
Credit/Deptstorecards 
$
Other commitments
Rent/board 
$
Rates/water/council
$
Gas/electricity/phone 
$
Vehicle(s) - Petrol
$
Vehicle(s)-Insurance/Registration/
Maintenance
$
Living (food, clothing, personal)
$
Superannuation 
$
Life/Incomereplacementinsurance 
$
Insurance-Contents/medicaletc 
$
Educationexpenses/Schoolfees/fares 
$
Child maintenance
$
Otherexpenditure 
$
Please specify:
Total net monthly expenditure (4)
$
Total assets (1)
$
Total liabilities (2)
$
Net assets (=1-2)
$
Total net monthly income (3)
$
Total net monthly expenditure (4)
$
Uncommitted monthly income (=3-4)
$
ANZ Business Credit Application Form
Page7of8
120343
Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522. Australian Credit Licence Number 234527.
Information Classification: Confidential
PERSONAL STATEMENT OF FINANCIAL POSITION 2
Astatementofpositionmustbecompletedby:-Eachapplicant(ifindividual)-EachDirector/Partner/soleproprietor(ifapplicantisacompany,
partnership or business)- Intending guarantors
Name (s)
As at
Total assets (1)
$
Total liabilities (2)
$
Net assets (=1-2)
$
Total net monthly income (3)
$
Total net monthly expenditure (4)
$
Uncommitted monthly income (=3-4)
$
ASSETS Present value
Bank account
$
Property - primary residence
Location:
$
Property - other
Location:
$
Location:
$
Location:
$
Motorvehicles(make/model) 
$
Make/model
$
Make/model
$
Make/model
$
Furniture/householdgoods
$
Superannuation
$
Held with:
Shares 
$
Personal equity in any private business
$
Life insurance
$
Held with:
Other assets
$
Please specify:
Total Assets (1)
$
LIABILITIES
Loan Current outstanding
Personal Overdraft(s)
Limit(s) ANZ
$
$
Personal Overdraft(s)
Limit(s) Non-ANZ
$
$
Mortgage Loan(s) ANZ
$
Mortgage Loan(s) Non-ANZ
$
Other loan(s) ANZ
$
Other loan(s) Non-ANZ
$
Credit/Deptstore
card(s) Limit(s)
$
$
Other liabilities
Outstandingtaxationdue
//
$
Other
$
Please specify:
Other
$
Please specify:
Total Liabilities (2)
$
INCOME AVERAGE MONTHLY
Base salary gross (p.m.) Net (p.m.)
Income earner 1
$
$
Incomeearner2
$
$
Other income Net
Regular overtime
$
Part-time/casualemployment
$
Dividends/Interest
$
Commission
$
Rent received
$
Annual gross
$
x75%*
$
*Donotshowrentalpropertyexpensesasaseparateexpenseitem
Other income
$
Please specify:
Other income
$
Please specify:
Total net monthly income (3)
$
EXPENDITURE AVERAGE MONTHLY
Credit commitments
Housing loan repayments
$
Other loan repayments
$
Financelease/hirepurchaserepayments 
$
Credit/Deptstorecards 
$
Other commitments
Rent/board 
$
Rates/water/council
$
Gas/electricity/phone 
$
Vehicle(s) - Petrol
$
Vehicle(s)-Insurance/Registration/
Maintenance
$
Living (food, clothing, personal)
$
Superannuation 
$
Life/Incomereplacementinsurance 
$
Insurance-Contents/medicaletc 
$
Educationexpenses/Schoolfees/fares 
$
Child maintenance
$
Otherexpenditure 
$
Please specify:
Total net monthly expenditure (4)
$
ANZ Business Credit Application Form
Page 8 of 8
DECLARATION OF PURPOSE
I/Wedeclarethatthecredittobeprovidedtome/usbyANZpursuanttothisCreditApplicationistobeappliedwhollyorpredominantlyforbusiness
purposes; or investment purposes other than investment in residential property (or for both purposes).
Important: You should only sign this declaration if each one of these loans are 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
Signature Signature
Printed Name Printed Name
Date(DD/MM/YYYY) Date(DD/MM/YYYY)
Signature Signature
Printed Name Printed Name
Date(DD/MM/YYYY) Date(DD/MM/YYYY)
PRIVACY AND CONFIDENTIALITY STATEMENT
ANZ’s collection, use and disclosure of personal information
“Personal information” means information about an individual. This statement applies
to you if you are a representative of a customer(forexample,acompanydirectoror
officer). ANZ is collecting your personal information for the purpose of identifying you,
assessing and, if approved, providing the customer with the product or service applied
for. Without this information ANZ may not be able to do these things. ANZ may
disclose your personal information to: any service provider ANZ engages to carry out
or assist its functions and activities; credit reporting agencies; and other persons ANZ
is authorised or required by law to disclose information to (and other persons where
you have consented to the disclosure). By signing this application form, you consent to
ANZ disclosing your information to these persons.
This statement applies to you if you are a third party relevant to a customer (for
example,aguarantor). By signing below, you agree to ANZ doing the following things.
ANZ is collecting your personal information for the purpose of identifying you,
assessing and, if approved, providing the customer with the product or service applied
for. Without this information ANZ may not be able to do these things. ANZ may
disclose your personal information to: any service provider ANZ engages to carry out
or assist its functions and activities; credit reporting agencies; and other persons ANZ
is authorised or required by law to disclose information to (and other persons where
you have consented to the disclosure). Credit report ANZ may: obtain a credit report
containing personal information and use that information to assess whether to accept
you as a guarantor of credit applied for by the applicant. This statement applies to you
if you are a non-incorporated customer of ANZ(forexample,asoletraderorfirm).By
signing below, you agree to ANZ doing the following things. ANZ is collecting your
personal information for the purpose of assessing your application and, if it is
approved, to provide you with the product or service you are applying for. Without
this information ANZ may not be able to do these things. ANZ may disclose your
personal information to: any service provider ANZ engages to carry out or assist its
functions and activities; participants in the payments system (including financial
institutions, merchants and payment organisations); credit reporting agencies; ANZ’s
alliance partners; your referee; any credit provider to assess a credit application, to
assess your credit worthiness, to help you avoid default on your obligations or to
inform them of your default; your guarantors, or any person who has provided
property as security, for a loan that you or a joint borrower have with ANZ; and other
persons ANZ is authorised or required by law to disclose information to (and other
persons where you have consented to the disclosure). Credit report ANZ may: obtain a
credit report containing personal information and information about your commercial
activities and commercial credit worthiness from any business which provides that
type of information; and use that information to assess your credit application.
Promotion of other products or services
You agree to ANZ using your personal information to promote its products or services
or those of its related companies and alliance partners and disclosing your personal
information to its related companies or alliance partners to enable them or ANZ to
market their products or services. Where you do not want ANZ to tell you about its
products or services or those of its related companies or alliance partners, you may
withdraw your consent by calling 13 13 14. Your agreement to the use and disclosure
of your personal information applies to any personal information collected by ANZ in
the course of your relationship with ANZ.
You may request access to your information at any of our branches. Access will be
granted in accordance with the Privacy Act 1988 for a reasonable fee. If any of your
information is inaccurate, you may request that it be corrected.
Sensitive information ANZ will not collect sensitive information about you such as
health information, without your consent.
Confidential Information - Non Individuals This statement applies to you if you are a
nonindividualcustomerofANZ(forexampleacompany, trust, association or other
incorporated entity). You authorise ANZ to give confidential information to: any
contractor or service provider ANZ engages to provide services connected with your
relationship with ANZ or to develop, review or maintain its business systems;
participants in the payments system (including financial institutions, merchants and
payment organisations); its related companies or its alliance partners to promote their
products or services where they have agreed to only use the information for this
purpose and keep the information confidential; and your guarantors, or any person
who has provided property as security, for a loan that you or a joint borrower have
withANZ.Bysigningthisapplicationformyougiveexpressconsenttosuch
confidential information being disclosed to these persons or entities.
SIGNATURE AND DECLARATION
To be signed by all individual applicants, on behalf of all business applicants, by all
directors/sole trader/partners of business applicants and by existing guarantors. My
signature below evidences my understanding and consent to all matters set out in this
applicationincludingthePrivacyandConfidentialityStatementabove.Bysigning
below,Iconfirmthatallinformationprovidedbymeinand/oraccompanyingthis
application is true and is given in support of this application. Where the applicant is a
companypartnershiporbusiness,IdeclareIamadirector/soletrader/partnerofthe
business applicant and make this declaration on behalf of the applicant. I confirm that
the business is solvent and can afford to repay the increased facilities sought. Where a
statementofpositioniscompletedbymeasdirector/soletrader/partnerofthebusiness
applicant or guarantor of the applicant, I also make this declaration in my personal
capacityanddeclarethatthedetailscontainedinmyPersonalStatementofFinancial
Position are true and correct. Where signed by two or more people, this declaration and
consent is to be read as given by each individually. I acknowledge that ANZ reserves the
right to ask for additional information to consider my loan and that ANZ may not be able
to assess my application unless I provide any additional information requested by ANZ.
120343
Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522.AustralianCreditLicenceNumber234527.ItemNo.12034306.2012W277434
Information Classification: Confidential
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ANZ Business Credit Application Form (Australian National University)

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Completed 28 March 2021

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