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Client

Application	Application Date	Status
	1/08/2010 1:25:10 AM

Application Details

Authorization
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all of the information)

You give your authorisation to Evergreen Finance Company to seek information about your credit standing and history. You also agree that Evergreen Finance Company may obtain confirmation of your income, employment and residential information, which may be used for the purpose of assessing your application for credit. Evergreen Finance Company reserve the right to confirm and verify any of the information given on this application. I ACCEPT [I intend my click on this button to be my signature and by clicking I agree to the above statement and its terms]

I AgreeI DO NOT Agree

Loan Amount

Product Type / Loan Purpose

First Payment Due In

Loan Term (Months)

Acknowledgements

Are you at least
18 years old?

Are you an Australian Citizen / Permanent Resident?

Have you ever been bankrupt?

Do you authorise us to provide you
with information about products and
services which may be supplied by us,
any of our members or our preferred
partners that may be of interest to you?

YesNo

How many people are applying for this loan?

Applicant email address

How did you hear about us?