Loan Application Form (Page 3 of 5) in pdf

Loan Application Authorisation

(Pursuant to section 14 of the Credit Contracts and Consumer Finance Act 2003)

I/We the named Borrower(s) hereby make application to TSB Bank for financial Facilities (“the Facilities”).

Borrower(s):

Covenantor(s):

Privacy Act 1993

Pursuant to the Privacy Act 1993:-

1. I/We acknowledge that the personal information contained in the Application has been collected by TSB Bank (“the Bank”) for the assessment of my/our

application for the Facilities from the Bank.

2. I/We consent to the Bank giving that personal information to a mortgage insurer and/or credit card repayment insurer for the purposes of obtaining Lenders’

Mortgage Insurance and/or credit card repayment insurance if I/we have requested such insurance.

3. I/We consent to the Bank or its authorised agents and any mortgage or credit card repayment insurer:

- giving personal information about me/us to; or

- collecting personal information about me/us from;

any persons deemed necessary by the Bank or the mortgage or credit card repayment insurer and authorise all such persons to provide such information

requested for the purposes of:

- assessing the application for the Facilities;

- assessing an application by the Bank for Lenders’ Mortgage Insurance or credit card repayment insurance;

- providing the Bank with (if requested) Lenders’ Mortgage Insurance or credit card repayment insurance;

- making or reporting any claim by the Bank or the mortgage insurer or credit card repayment insurer relating to the Facilities; or

- administering the Facilities provided by the Bank or securities provided by me/us in favour of the Bank.

Personal Information Rights Statement

Pursuant to the provisions of the Privacy Act 1993, the Bank hereby makes you aware of the following points in respect of information about you which you are now

providing or which the Bank or its authorised agents or its mortgage insurer or credit card repayment insurer may now or at any time in the future hold:

1. The Bank may require to use the information obtained for use by other departments or divisions of the Bank including (but not by way of limitation) Marketing,

TSB Realty, Lending, VISA, Foreign Exchange and marketing/underwriting companies engaged by the Bank or in association with the Bank for product

promotions by Direct Mail, Telemarketing or other Direct Marketing activities.

2. The Bank may wish to seek your views on the services and products it offers. To this end, the Bank may provide appropriate information to reputable

marketing/underwriting companies engaged by the Bank.

3. The Bank will ensure that information about you is held securely and will not, except for the above purposes or as authorised by you, when required or

authorised by law, disclose the information to any person.

4. The Privacy Act 1993 gives you the right to see and correct information about you held by the Bank, its authorised agents and its mortgage insurer or credit card

repayment insurer.

Right of cancellation – payment of expenses

I/We agree that if I/we exercise my/our right under section 27 of the Credit Contracts and Consumer Finance Act 2003 to cancel any consumer credit contract entered

into recording the terms of any of the Facilities, I/we will pay to TSB Bank a Loan Cancellation Fee.

Goods and Service Tax (GST)

I/We certify, that I/we am/are: (Delete as appropriate)

- Registered for GST under IRD number

- Not registered for GST purposes and undertake to immediately advise the Bank should we become so, or transfer property to, a GST registered party.