Skip to content
Home
About
Points of Difference
Services
Commercial Finance
Community Partnerships
Mortgages
SMSFs
How to Refer
Referral Management System
Partner Benefits
Client Benefits
Member / Banker Logins
Banker Login
Member Login
News
Fundraising
Contact
Accreditation Application
Phone us today!
1300 782 131
Home
About
Points of Difference
Services
Commercial Finance
Community Partnerships
Mortgages
SMSFs
How to Refer
Referral Management System
Partner Benefits
Client Benefits
Member / Banker Logins
Banker Login
Member Login
News
Fundraising
Contact
Accreditation Application
Accreditation Application
Accreditation Application
Your First Name
*
Your Last Name
*
Your Email
Section A
Referring Entity Name (as per Nexus Partners Referral Agreement)
*
Referring Entity ABN
*
Is the ABN registered for GST?
*
Yes
No
Registered Address
*
Address Type
*
Commercial
Residential
Website Address
Email Address
*
Phone
*
Fax
Provide a Description/Overview of your Business Activity Description
*
How many years have you been operating?
*
List any industry accreditations/business related memberships in place
*
Referring Entity Type?
*
Australian Proprietary Company
Joint Venture
Partnership
Sole Trader
Trust
If you selected Sole Trader, please go to Section B. Otherwise, list all directors of Referring Entity.
Director 1 Name
Director 1 DOB
Director 2 Name
Director 2 DOB
Director 3 Name
Director 3 DOB
Director 4 Name
Director 4 DOB
Do any of the directors hold an ACL or Credit Representative Status under an ACL?
Yes
No
Do any of the directors have ownership/directorship of an entity which holds an ACL or Credit Representative Status under an ACL?
Yes
No
If the answer to either of the above is Yes, please provide details of ASIC licence/representative number and EDR membership body and number.
Please select service you would like more information on.
Financial Planning Referral Service
General Insurance Referral Service
Property Advocate Referral Service
Vehicle Equipment Finance Service
Section B - Sole Traders Only
First Name
Last Name
Date of Birth
How will you be sourcing referrals?
From own Business Activity as sole trader
As employee of another business
As contractor of another business
What is the name of the Business from which you will be sourcing referrals?
What is the ABN of the Business from which you will be sourcing referrals?
What is the Registered Address of the Business from which you will be sourcing referrals?
List all Directors of the Entity from which you will be sourcing referrals
Director 1 Name
Director 1 DOB
Director 2 Name
Director 2 DOB
Director 3 Name
Director 3 DOB
Director 4 Name
Director 4 DOB
Does the business from which you will be sourcing referrals offer a mortgage broker service or have a connection to a mortgage broker service?
Do you have the consent of the directors of the Business from which you will be sourcing referrals to refer clients to Nexus Partners for Finance?
Section C
Name of Referral Entity
Accredited Individual Details
Name
Date of birth
Drivers licence number
Home address
Phone number
Email Address
Please list industry Accreditation Details (for example Real Estate Licence Number, CPA Membership Number, AFSL/AFSR Number, Migration Agent Registration Number)
Please list any current / past lender or aggregator accreditations held in your own name
Declarations
Have you or any of your associates ever declared bankruptcy?
Yes
No
If yes, provide details
Have you or any of your associates ever been found guilty of an offence involving fraud, dishonesty, drug trafficking or anti money laundering?
Yes
No
If yes, provide details
Has your accreditation ever been refused or revoked with any other lenders?
Yes
No
If yes, provide details
Consent
*
I have completed this form and declare the information I have provided to be true and correct.
