Mortgage Brokers Application Form

Before you start….

Thank you for applying for a VIP Cashflow Advance loan. How you get your first payment is quick and easy. We will deposit money into your bank account within 48 hours provided this form is completed and meets the agreement guidelines.

IMPORTANT: In order to process your application we must receive a printed, signed copy of the Privacy and Confidentiality Statement from you.

DOWNLOAD, PRINT AND SIGN NOW

Please print, sign and email back to info@vipcashflow.com.au

Step 1: Complete an Application Form

If this is the first time you have used VIP Cashflow, you will need to complete an Application form and upload or email a copy of the following documents:

Option 1 – Insurance Broker Fee or Commission Funding

Fill out the online application form and upload/email us a copy of the following documents to info@vipcashflow.com.au:

Copy of Your Driver’s license (first time only)
Copy of Your Medicare Card (first time only)
Copy of Statement that shows the Relevant Commission or Fee that is due to you

Option 2 – Insurance Broker Trail Book Funding

Fill out the online application form and upload/email us a copy of the following documents to info@vipcashflow.com.au:

Copy of Your Driver’s license (first time only)
Copy of the most recent Plan Trail Book Statement from your provider.

Step 2: Review and Acceptance

Once we have received your application we review it and approve it (subject to it meeting our guidelines). At this moment we will conduct a Personal, Company Check. We will then send you an Agreement where the terms and agreed settlement date are listed. Simply sign this and email it back.

Step 3: Money in your Account

Once we have received the Commission Advance Agreement, we will then deposit Commission directly into your account, less the relevant interest and fees owing to VIP Cashflow

For any questions you can contact us on 1300 736 676.

Name*
First Middle Last
Date of Birth*
DD slash MM slash YYYY
Drivers License*
Home Address*
Street Address Address Line 2 Suburb State Postcode
Mobile Phone*
Home Phone*
Office Phone*
Email (primary)*
Second Email*
Third Email
Years in Industry*
Are you self employed?*
- Yes
- No
Years with current Company/Business*
Name of Previous Employer*
Are you trading as an Individual, Sole Trader, Business, Company, or Trust?*
Are you the director?
- Yes
- No
Company Name*
ACN / ABN*
Registered Address*
Street Address Suburb State Postcode
Bank*
BSB*
Account Name*
Account Number*
Principal place of business (if any) - NOT a Post Office box*
Street Address Suburb State Postcode Country
Your Company/Business Information
Company / Business Name*
Email: Principal in Charge*
Email: Sales Manager*
Email: Payroll / Office Administrator*
Office Address*
Street Address Suburb State Postcode
Office Phone*
Office Email Address*
Office Fax Number
Details of Loan Required
Loan amount required (after interest and charges)*
Expected Term*
Expected Settlement Date*
DD slash MM slash YYYY
Loan Purpose*
How will you repay?*
Give Details:
Additional Comments
Additional Information required by the AML/CTF Act
Name of Industry*
Reason for customer requiring our services (include supporting documents, for example, agency or commission agreements)*
If 'other' provide more detail:*
Name of industry in which the customer operates?*
If 'other' provide more detail:
Explanation of a typical service provided by you to your customers?*
If 'other' provide more detail:
For Individuals, Sole Traders and Businesses
Is the individual a citizen or hold a passport or a working visa for any other country? (eg dual citizenship)(if yes, provide details)
- Yes
- No
If YES give details:
The customer’s approximate annual income
And the source of that income:
Do any individuals hold a prominent public position or function in a government body or an international organization (ie a politically exposed person (‘PEP’)?*
Click here for explanation of PEP
If 'Yes' provide more detail:
Is the individual customer an immediate family member or close associate of a PEP? If so, provide details.*
Click here for explanation of PEP
If 'Yes' provide more detail:*
For Companies and Trusts
Upload supporting documents (PDF)
Drop files here or

Accepted file types: pdf, Max. file size: 5 MB, Max. files: 5.
What is the approximate annual income of the Company applying?*
What is the approximate annual income of the Trust applying?*
Is that income derived solely from your day to day business?*
If 'NO' please explain other means of annual income:
Do any beneficial owners hold a prominent public position or function in a government body or an international organization (ie a politically exposed person (‘PEP’)?*
Click here for explanation of PEP
Do any trustees or beneficial owners hold a prominent public position or function in a government body or an international organization (ie a politically exposed person (‘PEP’)?*
Click here for explanation of PEP
If 'Yes' provide more detail:*
Are any individuals identified above an immediate family member or close associate of a PEP?*
Click here for explanation of PEP
If 'Yes' provide more detail:*
Do any beneficial owners hold a prominent public position or function in a government body or an international organization (ie a politically exposed person (‘PEP’)?*
Click here for explanation of PEP
Do any individual trustees or beneficial owners hold a prominent public position or function in a government body or an international organization (ie a politically exposed person (‘PEP’)?*
Click here for explanation of PEP
If 'Yes' provide more detail:*
Are any beneficial owners an immediate family member or close associate of a PEP?*
Click here for explanation of PEP
Are any individual trustees or beneficial owners an immediate family member or close associate of a PEP?*
Click here for explanation of PEP
If 'Yes' provide more detail:*
Full Name of Trust*
Type of Trust*
Country where Trust was established:*
Full name of the settlor of the trust*
How many directors are there?
Please enter a number from 1 to 100.
List Directors Names: (separate with a comma)
How many trustees are there?*
Trustee 1
- Company
- Individual
Trustee 1: Company Name
Trustee 1
First Middle Last
Trustee 1: Residential/Primary Business Address (Not PO Box)
Street Address Address Line 2 Suburb State Postcode Country
Trustee 2
- Company
- Individual
Trustee 2: Company Name
Trustee 2
First Middle Last
Trustee 2: Residential/Primary Business Address (Not PO Box)
Street Address Address Line 2 Suburb State Postcode Country
Trustee 3
- Company
- Individual
Trustee 3: Company Name
Trustee 3
First Middle Last
Trustee 3: Residential/Primary Business Address (Not PO Box)
Street Address Address Line 2 Suburb State Postcode Country
How many beneficiaries/beneficial owners are there?*
First Beneficial Owner
First Middle Last
Date of Birth (if beneficial owner is individual)
DD slash MM slash YYYY
Residential Address (PO Box not permitted)
Street Address Suburb State Postcode Country
Second Beneficial Owner
First Middle Last
Date of Birth (if beneficial owner is individual)
DD slash MM slash YYYY
Residential Address (PO Box not permitted)
Street Address Suburb State Postcode Country
Third Beneficial Owner
First Middle Last
Date of Birth (if beneficial owner is individual)
DD slash MM slash YYYY
Residential Address (PO Box not permitted)
Street Address Suburb State Postcode Country
Terms & Conditions: Privacy & Confidentiality*
- YES, I have downloaded, signed and returned the Privacy and Confidentiality Statement, via email to info@vipcashflow.com.au with this application. I understand this application will not be processed until a signed copy of this statement is received.
Name
This field is for validation purposes and should be left unchanged.

Insurance Brokers

Before you start….

IMPORTANT: In order to process your application we must receive a printed, signed copy of the Privacy and Confidentiality Statement from you.

DOWNLOAD, PRINT AND SIGN NOW

Please print, sign and email back to info@vipcashflow.com.au

Your Company/Business Information

Details of Loan Required

Additional Information required by the AML/CTF Act

For Individuals, Sole Traders and Businesses

For Companies and Trusts