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Advance Application

 

Where did you hear about us?

 

Complete all fields where possible. Any omissions may delay your application being processed promptly.

PRE-QUALIFICATION  
Over 18 years of age?  YES  NO
Employed by the same employer for at least 3 months?  YES  NO
Held an Australian bank account for at least three months?  YES  NO
Income paid directly into your Australian bank account?  YES   NO
Sufficient income to facilitate repayment of any advance?  YES  NO
PRIVACY PROTECTION STATEMENT & DECLARATION  

CLICK HERE to read our Privacy Protection Statement & Declaration before proceeding.

  AGREE   
Select 'Agree' to indicate you are ready to proceed or contact us for further information.  DISAGREE

ADVANCE DETAILS

  
How much would you like to borrow? ($100 to $500) 
How long do you require the funds? 
What repayment frequency do you prefer? 
Nominated Single / First Repayment Date 
PERSONAL DETAILS  
Title Last Name 
First Name Middle Name(s)
Date Of Birth Dependants 
Licence NumberMedicare Number 
Home Phone Home Fax 
Mobile Phone Other 
Email Confirm Email 
ADDRESS DETAILS  
Address Line 1 
Address Line 2
City / Suburb State 
Country Postcode 
Time at this address?   
Landlord NameLandlord Phone 
PREVIOUS ADDRESS DETAILS (Required if less than 3 years at current address)
Address Line 1
Address Line 2
City / SuburbState 
Country Postcode 
Time at this address? 
EMPLOYMENT DETAILS  
Employer Name Employer Phone 
Employer Contact Employer Email
Employer Address Line 1 
Employer Address Line 2
City / Suburb State 
Country Postcode 
Occupation Employment Type 
Years / Months Employed Gross Annual Income 
Pay Day / Date Payment Frequency 
Previous Employer NameYears / Months Employed
EXISTING LOANS  
Any existing loans?   
Total Loans Value Monthly Loan Repayments 
SPOUSE / PARTNER / EMERGENCY CONTACT DETAILS  
First Name Middle Name(s)
Last Name Relationship
Home PhoneMobile Phone 
REFERENCE 1  
Name Relationship
Home Phone Mobile Phone 
REFERENCE 2  
Name Relationship
Home Phone Mobile Phone 
BANKING DETAILS  
Bank Name Account Name 
BSB Number Account Number 
ACCOUNT ACCESS (Required to access your account information after establishment)
Username   
Password Confirm Password 
COMMENTS  
OBTAINING & EXCHANGING INFORMATION ABOUT INDIVIDUALS

Although My Cash Base Pty Ltd does not undertake credit checks prior to providing funds, by selecting 'Accept' below, you authorise us, in the event of a default, to:

1.

obtain information about you from a credit reporting agency;

2.

obtain information about you from your employer;

3.

exchange information about you with those credit providers named in a consumer credit report obtained by us for the following purposes:

 

i.

to notify other credit providers of a default by you;

 

ii.

to exchange information with other credit providers regarding the status of your account where you are in default with other credit providers; and

4.

to assess your credit worthiness.

    ACCEPT  DO NOT ACCEPT 
    

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