Application Form

Between Fix My Credit ("provider")
And:
Previous residential address
Surname
Middle Name
First Name

Date of Birth (Day/Month/Year):

Have you used a credit repair agency before ?
 Yes No
Name of institution used:
How did you hear about us?
Please name the consultant you are dealing with
Please state your email address
Please reconfirm your email address
Have you ever used another name?
 Yes No
Please state full previous name used:
Sex
 Male Female
Current Drivers License Number
Daytime Phone Number
Name of current employer
Are you currently bankrupt or in a Part 9/10 debt agreement
 Yes No
Please list defaults/court judgements on your credit file: (If you are unaware of these listings an estimate is fine)
The client retains the provider to provide the services to the client subject to the terms and conditions attached to this page and on the basis of the information the client supplies to the provider as shown on this page. In accordance with sections 20R and 6L of the Privacy Act 1988 (Cth), the client authorises the provider to request a copy of the clients credit reporting information as an access seeker and to liaise with all credit reporting agencies including Veda Advantage by phone, fax, internet or any way seen fit by the provider on behalf of the client.
  By ticking this box you are here by accepting the above terms and conditions on this agreement page
Signed
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
1. In this agreement, "administrations" implies the arrangement by the supplier to the customer of:
(an) A report about credit status including the importance of the length of the season of that status, how to change the status if inaccurately reported and recorded, how to react to obligation gathering administrations, how to clean your credit document and how to keep up a decent credit status or record;
(b) A duplicate of the customer's credit document as made from information accessible from organizations that give an account of creditworthiness;
(c) The report by express post or messaged.
2. The supplier must utilize its best attempts to give the administrations. 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.
3. The customer unavoidably and unequivocally approves and guides the supplier to contact, and liaise with, all credit reporting organizations including Veda Advantage to get the customer's records of creditworthiness by method for phone, email, web access, copy or in any case that the supplier sees fit and approves the supplier to supply this agreement to the credit reporting substances so as to give the administrations.
4. The customer warrants that the information the customer gives to the supplier is valid and amend.
5. The administrations as characterized above particularly do exclude fund broking, instructing about the achievement or generally concerning a customer's application for back with any agent or something besides the administrations as characterized previously. The customer recognizes that the supplier makes no representation or guarantee of redressing or changing the customer's records of creditworthiness with any organization or reporting body or in getting fund howsoever nor does meeting the supplier’s criteria/being affirmed for our administration guarantee any of the above.
6. The customer consents to pay the supplier's held charge for giving the administrations as characterized above just, One thousand and ninety five dollars Inc. GST upon the supplier tolerating the customer’s application and at the customer's carefulness.
7. The customer approves the supplier to present a demand to debate postings for the customers benefit on the customer’s credit history and at the supplier’s prudence to either the budgetary administrations ombudsman, media communications ombudsman, credit and speculation ombudsman, any of the power and water ombudsman's, any credit reporting body of the suppliers picking and some other ombudsman. The customer recognizes this should be sans possible of charge, however utilizes the supplier to help with the procedure.
8. 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. The customer additionally recognizes the supplier: -
(a) Has not depended on any representation or actuations at all other than those written in this agreement. (b) Has had the chance to get free legitimate and money related advice and either:-
(i) Acknowledges that advice and consents to this arrangement appropriately; or
(ii) Waives the privilege to get that advice and consents to this arrangement as needs be
Your details are kept confidential