Application Form - Livestock - Landmark

Application for Livestock Deferred Terms
Account No:
Borrower “I”
Are you (please tick ( ) where applicable) a Company a Partnership a Trust Individual(s)
Company name: (if applicable) ABN:
Trading name: (if applicable)
Trading name: (if applicable)
Name of Individual’s, Company Director’s, Partners, Trustees
Surname: Given names:
Address: Date of Birth:
Surname: Given names:
Address: Date of Birth:
Surname: Given names:
Address: Date of Birth:
Surname: Given names:
Address: Date of Birth:
Therefore the name of the account will be:
Contact Details
Postal Address: Postcode:
Phone - Business: Private: Fax:
Email:
Accountant/Consultant details
Contact: Firm:
Address: Postcode:
Phone No: Fax: Email:
Do you have farm insurance: Yes / No
If Yes:
Name of provider: Sum Insured: Renewal Date:
20-Sep-11 Landmark Operations Limited ABN 73 008 743 217 1

Livestock details, information required for credit check
Please complete and enclose the following forms (each of which form part of your application) with your
application:
- Statement of Assets and Liabilities including;
o Statement of Livestock Numbers and Values;
o Water Licenses / Entitlements
o Plant values
o Crop (Previous two years)
- Livestock Budget
- NLIS 3 rd party Authorisation
Loan Details
Loan amount requested: $
Financial Details
Does anyone hold a charge / security over the Livestock? (please tick ) Yes No
If yes to whom:
a) I apply for a loan to be used for business purposes. If you (as the credit provider) approve this application
and provide me with a loan, I agree that the terms and conditions enclosed with this application form will
apply to my loan, and also confirm the acknowledgment and other statements which I make on pages 4, 5
and 6 of this application form.
b) I declare that the information provided in my application for the loan including the information provided in the
enclosed (1) Statement Assets and Liabilities; (2) Livestock Budget; and (3) NLIS 3 rd party Authorisation
(each of which form part of my application) is true and complete and includes an accurate summary of my
financial position.
c) I acknowledge that the representations made to you by me may be relied on by you in assessing this loan
application. I am authorised to sign this application for and on behalf of the applicant.
d) I consent to the matters set out in the Privacy Consent And Acknowledgment Section appearing on pages 2
and 3 of this application.
e) I declare that the credit to be provided by you is to be applied wholly or predominantly for business purposes
(or for both purposes).
IMPORTANT
You must not sign this declaration unless the loan is wholly or predominantly for business. By signing this
declaration you may lose your protection under the National Credit Code.
Date: Note: Each individual, Company Director, Partner and Trustee to sign
Signature: Signature:
Name:(printed) Name:(printed)
Signature: Signature:
Name:(printed) Name:(printed)
20-Sep-11 Landmark Operations Limited ABN 73 008 743 217 2

Privacy Consent and Acknowledgement by Applicants and Guarantors who are individuals and any
other individuals about whom personal information is collected by Landmark in relation to this
application
A. Important Information
This section sets out important information about how Landmark Limited ABN 73 008 743 217, (“Landmark”) will
use and disclose any personal information provided to Landmark in and in connection with this application. The
disclosures, information and consents contained in this section also apply to any other personal information
Landmark collects or has collected at any time in connection with this application or the loan (if granted).
In handling personal information, Landmark will comply with the Privacy Act 1988 (Cth) (Privacy Act) and with
the ten National Privacy Principles (NPPs) in the Privacy Act.
The personal information provided in and in connection with this application is collected by Landmark.
Individuals about whom Landmark holds personal information can contact Landmark with any queries about how
Landmark manages their personal information by telephoning Landmark’s Privacy Officer on (02) 9335 6000 or
in writing to Landmark at Landmark, GPO Box 261, Sydney, NSW 2001.
Where Landmark holds personal information about an individual, that individual can gain access to their
personal information, subject to any limitations imposed by the Privacy Act or the NPPs.
Landmark collects personal information for the purpose of assessing this application and, if this application is
successful, providing the applicant with and administering the loan.
Landmark also collects personal information to provide the applicant with information that may be of interest to
the applicant and about other products and services offered by the members of Landmark and other companies
associated with those members (in which case Landmark may disclose such personal information to these
companies). If an individual does not agree to Landmark using their personal information for this purpose, they
may instruct Landmark not to by telephoning Landmark’s Privacy Officer on (02) 9209 2000 or in writing to
Landmark at Landmark, GPO Box 4562, Melbourne, Vic 3001.
Landmark also usually discloses personal information collected in and in connection with this application to:
• Organisations to whom Landmark outsources its mailing, financial processing, information technology, data
storage and other functions which assist Landmark in providing the applicant with financial services (for
example, its valuers, solicitors and auditors);
• The applicant’s accountant, insurers and real estate agent;
• The persons referred to in paragraphs 1-4 below;
• State and Federal Government Authorities (for example Office of State Revenue, Land Titles Office, ASIC);
• If this application has been referred to Landmark, the intermediary who made the referral; and
• Anyone authorised by the individual to whom the personal information relates.
If the applicant does not give Landmark all of the personal information as required by this application, Landmark
may refuse to consider the application or be unable to administer the applicant’s loan (if granted).
B. Privacy Consent
To enable Landmark to assess this application for credit and whether to accept this application,, the
individuals who sign below (“you”) agree that Landmark may:
1. Give personal information about you to, or seek personal information about you from, a credit reporting
agency for the purposes of assessing your credit worthiness or the creation of a credit information file. This
information may include (where applicable):
• Identity particulars;
• The fact that you have applied for credit with Landmark and the amount;
• The fact that Landmark is a credit provider to you;
• Payments which are overdue more than 60 days and for which collection action has commenced;
Landmark Operations Limited ABN 73 008 743 217 3

• Cheques drawn by you which have been dishonoured more than once;
• Advice that payments are no longer overdue;
• In specified circumstances, that in Landmark’s opinion you have committed a serious credit infringement;
• That the credit provided to you by a member or members of Landmark has been discharged.
2. Give to and seek from any credit providers named in this application (or material provided with this
application) or named in a credit report received from a credit reporting agency information about your credit
arrangements including information contained in and with this application and any other information about your
credit worthiness, credit standing, credit history or credit capacity (“Credit Arrangements Information”). You
understand that this information may be used for the following purposes (where applicable):
• To assess an application by you for credit;
• To assist you to avoid defaulting on your credit obligations;
• To tell other credit providers about a default by you for the purposes of assessing your credit worthiness;
• To asses your credit worthiness; and
• To assess whether to accept you as a guarantor of credit applied for.
3. To enable Landmark to assess whether to accept you as a guarantor (if applicable), get reports about your
credit worthiness from a credit reporting agency or other business that provides information about credit
worthiness. These reports may contain:
• Personal information about you in relation to this application;
• Personal credit information and commercial credit information about you in relation to this application;
• Information about your commercial activities or credit worthiness in relation to this application;
• Other information in relation to your commercial credit activities.
4. Give Credit Arrangements Information to and obtain Credit Arrangements Information from:
• The applicant;
• Any guarantor or prospective guarantor of any obligations to Landmark under the proposed facility at any
time;
• Any person who has provided, provides or is considering providing financial accommodation to you or who
has taken or may take any form of security from you including companies associated with a member of
Landmark;
• The persons and entities referred to in Part A of this Privacy Consent and Acknowledgement section;
• Any holder or valuer of an asset referred to in this application;
• Any legal or financial adviser of a person referred to in this subparagraph; and
• Anyone you authorise.
5. Disclose, use and obtain your personal information as set out in this Privacy Consent and Acknowledgment
Section. You acknowledge that, if this application is approved, then this Consent and Acknowledgment will
remain in force until the full amount owing to Landmark or companies related to Landmark under any credit
facility is repaid and all related accounts are closed.
Declaration and Signatures
By signing below, each person acknowledges and agrees with Landmark handling and managing their personal
information in accordance with the above Privacy Consent and Acknowledgement.
Signature: Signature:
Name:(printed) Name:(printed)
Date: Date:
Signature: Signature:
Name:(printed) Name:(printed)
Date: Date:
Landmark Operations Limited ABN 73 008 743 217 4