AUSWide Lending Partners

1 Personal Details

Full Name *

Driver's Licence No *

State of Issue *

Licence Expiry Date *

Date of Birth *

Employer

Gender *

Male Female Other

Street Address *

Suburb, State & Postcode *

2 Credit Check Authority

I Authorise Haripur Financial Services Pty Ltd ABN 89 689 210 115 Trading as AUSWide Lending Partners, Unit 11, 2 Distribution Drive, Mickleham VIC 3064, to act as my agent in seeking access to my consumer and commercial credit information file held by a credit reporting agency.

This authority only applies in connection with:

An Application, or proposed application, by me for credit.
My having sought advice in relation to existing credit.

Signature – Credit Authority *

Sign above with your mouse or finger

Date Signed *

3 Credit Report Fee – $33.00

I authorise Haripur Financial Services Pty Ltd ABN 89 689 210 115, Trading as AUSWide Lending Partners (Australian Credit Licence 384704), to collect an upfront fee of $33 by charging my Visa or Mastercard to produce a credit information report.

Cardholder Name *

Card Type:

💳 Mastercard

💳 Visa

Card Number *

Expiry Month *

Expiry Year *

CVC / CVV *

Signature – Payment Authority *

Sign above with your mouse or finger

Date Signed *

⚠️ Submitting authorises a one-time charge of $33.00 to your nominated card.

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Form Submitted Successfully

Thank you. Your credit check authority has been received.
AUSWide Lending Partners will be in touch shortly.

Authority for an agent to obtain an individual's consumer and commercial credit information file held by credit reporting agency (Privacy Act 1988)

Form Submitted Successfully