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Broker Details

Name as per photo identification

 
 

NCCP Details

Personal Identifier

The following information is required specifically for identity authentication purposes (i.e. To confirm caller identity prior to releasing confidential information). You must take reasonable measures to keep the nominated identifier confidential.

Broker Declaration and Acknowledgement

Have you ever:

Declared bankruptcy, been declared bankrupt, or been subject to control under the Bankruptcy Act 1966?

Been found guilty of, or been charged with any crime or offence (other than a minor crime such as traffic offence) which has not been withdrawn or dismissed?

Had an application for grant or renewal of any financial services license or registration, authorisation to act as a credit representative or membership of an industry or professional association refused or revoked?

Had an application for accreditation declined or been cancelled by any other credit provider?

Been banned from holding a company directorship?

Been known by or had any other name?

I acknowledge that:

  • This application for accreditation will be assessed by WLTH and that approval of this accreditation is at the discretion of WLTH. WLTH will notify me of the outcome for this application within 10 working days upon receipt of this fully completed application and all supporting documentation;
  • Approval of my 'new' accreditation is subject to the completion of the WLTH broker induction training;
  • If your accreditation is terminated, WLTH may report full details of the reasons for termination (including for dishonesty or fraud) and provide copies of relevant documents, to any Approved Industry Association and/or any government body which regulates or supervises the conduct of mortgage brokers and I will not hold the Bank liable for such reporting.