FrontRunner Aggregation Services Membership Application Form

Application Form:

Please complete a separate form for each Company Director / Business Partner (if applicable).
Please print and sign the completed application. You can click the Print button at the bottom of the page.

Full Member Name:

ABN:

Associate Name:

Associate Business Address:

Associate Mailing Address:

Telephone - Fixed:

Telephone - Mobile:

Fax:

Email:

Associate Member Details / Applicant

Name:

Home Address:

Date Of Birth:

Drivers Licence Number:

MFAA Membership #:

Expiry Date:

COSL Membership #:

Expiry Date:

FBAA Membership #:

Expiry Date:

PI Insurance Policy #:

Expiry Date:

GST Registered:

Bank Details:

Bank Name:

BSB:

Account Name:

Account Number:

Please provide two Referees from within the Lending industry:

Referee 1:

Name:
Lender:
Phone:

Referee 2:

Name:
Lender:
Phone:

Past experience with Mortgage Origination Industry:

Residential:

Commercial:

Plant & Equipment:

Consumer Finance:

Insurance:

With whom do you hold accreditation?

Please provide your accreditation details above and click Add. You can add as many accreditations as you like in this manner.
You can select multiple association types for an individual institution by holding CTRL while selecting.

Institution

Length of Association

Type of Association

Annual Volume Estimate

Years:
Months:

Declarations:

Have you ever had Professional Indemnity Insurance refused, cancelled, declined or had any special conditions imposed?
Have you ever been declared bankrupt, subject to any form of insolvency administration?
Have you been convicted of a criminal offence?
Have you ever entered into a Scheme of Arrangement with Creditors?
Have you had any default or judgement lodged against you?
Are you subject to a pending investigation or enquiry by or on behalf of any Stock Exchange / Government Department / Securities Commission / Banking Ombudsman and or similar regulatory or investigatory body?
Have you ever been prosecuted under the Trades Practices Act, UCCC or NCCP?
Have you ever had a lender accreditation refused, terminated or suspended for any reason?
Have you ever had an aggregators accreditation refused, terminated or suspended for any reason?
Have you ever had an industry association membership refused, terminated or suspended for any reason?
Do you currently hold that status of Accredited Mortgage Consultant with the Mortgage Industry Association of Australia (MIAA) or like body?
Do you currently hold that status of Accredited Mortgage Consultant with the Mortgage Industry Association of Australia (MFAA) or like body?
Have you ever been subject to disciplinary action by an Industry Professional Body?

Load Fraud Declarations:

In the last 10 years, have you:

Ever had a securities licence or proper authority refused, suspended, withdrawn or cancelled or been subject to a banning order?
Ever had a business related licence, registration or membership revoked, denied or suspended?
Have you ever been convicted of an offence involving criminal charges, or is there any charges pending?
Ever been refused membership of a statutory, professional or other body in respect of your professional capacity?
Ever been subject to disciplinary proceedings or expelled by a statutory body, professional or other body?
Ever been dismissed or had a proper authority withdrawn on ethical or legal grounds ?
Any past or pending claims made against your professional indemnity insurance?
Ever been refused professional indemnity insurance?

Privacy Acknowledgement and Consent:

Under this heading "we", "us" and "our" refer to FrontRunner Mortgage Group Pty Ltd A.C.N. 096 328 979 and Connective Services Pty Ltd ACN 107 366 496,

"you" and "your" refers to the Associate named as such in this application. "Full Member" refers to the Full Member named in this application.

Collection of Personal Information:
We collect personal information (including your full name, address and contact details) so that we may assess your application and administer our relationship with you and provide you with products and services you request as well as information on the Frontrunner Mortgage Group’s and or Connective Group’s products and services.

Where necessary to do so, we also collect information on individuals such as company directors and officers (where the company is our customer), as well as customers’ agents and persons dealing with us on a “one-off” basis.

You must provide us with accurate and relevant information:
If you provide us with incomplete or inaccurate information, we may not be able to assess your application and administer our relationship.

Other Members of the Connective Group:
We are permitted by the Privacy Act to disclose personal information to other members of the Connective Group.

Other Disclosures:
We may communicate personal information to organisations to which we outsource certain functions. For greater detail on outsourcing, please refer to our Privacy Policy Statement, which is available at www.frontrunnerbrokers.com.au and www.connective.com.au

In all circumstances where contractors and agents may become aware of personal information, confidentiality agreements apply. Our agents and contractors may only use personal Information for our purposes.

We may be allowed or obliged to disclose information by law, eg. Under Court Orders or Statutory Notices pursuant to taxation or social security laws.

Access:
You may (subject to permitted exceptions) access your information by contacting FrontRunner Mortgage Group Pty Ltd 3-5 Gladstone Street Wentworth Falls NSW 2782 or Connective OSN Pty Ltd, Level 5, 530 Collins Street, Melbourne VIC 3000.

Terms of Associate Membership of Connective Application:

Application:
These terms apply to you if your application is accepted by us. By signing below you agree to be bound by these terms.
You acknowledge and warrant that:

All information provided by you in this Application is true, complete and not misleading in any way;
You will comply with all directions from and all processes and procedures required by us, your Full Member, any Lender or provider of other related products that are available through us;
You will comply with all laws, regulations and industry codes of practice applying to your conduct
You have the qualifications, training, experience and expertise appropriate to conduct your services under this and the Full Member Agreement between us and the Full Member.
You hold all licences and accreditations required by Lenders and any state or federal government legislation to conduct its business, and will maintain such accreditations while you remain an associate member of Connective
You must always act honestly and diligently and with the highest standard of ethics and professionalism.
You must not engage in or allow any conduct that is dishonest, unethical, contrary to law, including without limitation that may mislead or deceive; and
You must always conduct yourself in a manner that is consistant with and that does not cause the Full Member to breach the terms of the Full Member Agreement between us and the Full Member.

You are responsible for your own conduct and you must indemnify us and keep us indemnified from all claims, suits, demands, liability, loss, damage, cost (including all legal costs on an indemnity basis), clawback or other liability in relation to or arising from:

Any action, inaction, negligence, wilful misconduct, fraud or other action by you; and
Any breach by you of the warranties and obligations in this Agreement or that would be a breach of the Full Member Agreement between us and the Full Member

Except as specifically set out here, we do not provide any services to you nor owe any obligations to you as our obligations and responsibilities are between us and the Full Member. As such, we do not make any representation or warranty about the quality, fitness for purpose or performance of the services and facilities offered by us, whether implied by statute, common law, trade usage, custom or otherwise, unless imposed by non-excludable law.

Connective will not be liable to you or any other person for any remuneration, payment, compensation, loss or damage owing to you or any other person or suffered by you or any other person as a result of the conduct, acts or omissions of the Full Member or any other person.

Signing
By signing the application below, you acknowledge:

I have read and understood the service expectations required of me if my application is successful;
I hereby declare that the information in this application is accurate and true and authorise Connective to confirm the details in this application with third parties as required;
In accordance with Connective's compliance procedures to appoint a Full Member or Associate Member, it is a requirement that each Full Member or Associate Member is identified and a credit search conducted;
That I authorise Connective to obtain reports from Veda Advantage Business Information Services Ltd to enable them to assess my application to become a Full Member or Associate Member;
That I provide consent to the use and disclosure of my personal information as set out above;
That I have been provided with the opportunity to read and have read and understood this document;
That you agree that the Terms contained in this application form the terms of the agreement between you and us.

Applicant Signature:

Date: ________/__________/20_______

Associate members either franchised, licenced or employed by the full member may be authorised to act, but will need to be accredited by the individual lender as well as being an approved associate member of Connective, prior to conducting any interview with clients.

FrontRunner Mortgage Group Consent For Applicant to become an Associate Member:

Signature:

Date: ________/__________/20_______

Director Frontrunner Mortgage Group
Connective Full Member

Frontrunner Mortgage Group Pty Ltd
PO Box 796 Katoomba NSW 2780
P: 02-95483395
F: 02 95483380
E: [email protected]

CONNECTIVE SERVICES PTY LTD (ACN 107 366 496)
Level 5, 530 Collins Street Melbourne VIC 3000
P: 03 96146080
F: 03 96293831
E: [email protected]