Fact Find Form

– Step 1 of 21

How many applicants will there be? *

Applicant 1

Applicant 1 Title

Applicant 1 Name

First

Middle

Last

Applicant 1 Gender

Applicant 1 Date of Birth (DOB)

Applicant 2

Applicant 2 Title

Applicant 2 Name

First

Middle

Last

Applicant 2 Gender

Applicant 2 Date of Birth (DOB)

Applicant 1 Mobile No.

Applicant 2 Mobile No.

Applicant 1 Home Phone No.

Applicant 2 Home Phone No.

Applicant 1 Work Phone No.

Applicant 2 Work Phone No.

Applicant 1 Email

Applicant 2 Email

Applicant 1 Current Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 1 Residential Status

Applicant 1 Please briefly explain other residential status: *

Applicant 1 Have you resided at your current address for more than 3 years?

Applicant 1 Please add in all previous addresses for the past 3 years

Applicant 1 Previous Residential Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 1 Previous Address Residential Status

Applicant 1 Start Date at Previous Residential Address?

Applicant 1 is your mailing address the same as your current residential address?

Applicant 1 Mailing Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 1 Settlement Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Is Applicant 2 address details exactly the same as Applicant 1 above?

Applicant 2 Current Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 2 Residential Status

Applicant 2 Please briefly explain other residential status: *

Applicant 2 Have you resided at your current address for more than 3 years?

Applicant 2 Please add in all previous addresses for the past 3 years

Applicant 2 Previous Residential Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 2 Previous Address Residential Status

Applicant 2 Start Date at Previous Residential Address?

Applicant 2 is your mailing address the same as your current residential address?

Applicant 2 Mailing Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 1 Country of Residency

Applicant 2 Country of Residency

Applicant 1 Citizenship of

Applicant 2 Citizenship of

Applicant 1 Australian Residential Status

Applicant 2 Australian Residential Status

Driver's Licence Details or NSW Photo Card

Applicant 1 Licence No. / Photo Card No.

Applicant 2 Licence No. / Photo Card No.

Applicant 1 State of Issue

Applicant 2 State of Issue

Applicant 1 Driver Licence Expiry Date

Applicant 2 Driver Licence Expiry Date

Passport Details

Applicant 1 Do you have a current passport?

Applicant 1 Passport No.

Applicant 1 Passport Issue Date

Applicant 1 Passport Expiry Date

Applicant 2 Do you have a current passport?

Applicant 2 Passport No.

Applicant 2 Passport Issue Date

Applicant 2 Passport Expiry Date

Applicant 1 Marital Status

Applicant 1 Do you have any dependents?

Applicant 1 Please add ages of all dependents

Applicant 1 Age of dependent

Press “Add” button below to input the age of additional dependents.

Applicant 2 Marital Status

Applicant 2 Do you have any dependents?

Applicant 2 Please add ages of all dependents

Applicant 2 Age of dependent

Press “Add” button below to input the age of additional dependents.

Applicant 1 Mother's Maiden Name

Applicant 1 Do you have a spouse?

Applicant 1 Spouse's Name

First

Last

Applicant 1 Next of Kin Name

Applicant 1 Next of Kin Relationship

Applicant 1 Next of Kin Phone No.

Applicant 1 Next of Kin Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 2 Mother's Maiden Name

Applicant 2 Do you have a spouse?

Applicant 2 Spouse's Name

First

Last

Applicant 2 Next of Kin Name

Applicant 2 Next of Kin Relationship

Applicant 2 Next of Kin Phone No.

Applicant 2 Next of Kin Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 1 Type of Employment

Applicant 1 Start Date of Becoming Unemployed

Applicant 1 Employment Status

Applicant 1 Employment Sector

Applicant 1 Company Name

Applicant 1 Company Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 1 Occupation Role

Applicant 1 Start Date With Current Employer

Applicant 1 Employer Contact Name

Applicant 1 Employer Contact No.

Applicant 1 Income Details

Applicant 1 Base Salary ($)

Applicant 1 Income Frequency

Applicant 1 Regular Overtime ($)

Applicant 1 Regular Commission / Bonuses ($)

Applicant 1 Regular Motor Vehicle Allowance ($)

Applicant 1 Regular Allowances – Other ($)

Applicant 1 Please Specify Type of Regular Allowances

Applicant 1 Existing Income e.g. Share Dividends

Applicant 1 Government Payment ($)

Applicant 1 Government Payment Type

Applicant 1 Please specify other type *

Applicant 1 If you have been in your current employment for less than 3 years, please enter your previous employment details up to 3 years below.

Applicant 1 Past Type of Employment

Applicant 1 Past Start Date of Becoming Unemployed

Applicant 1 Start Date with this Past Employer

Applicant 1 End Date with this Past Employer

Applicant 1 Past Employment Status

Applicant 1 Past Employment Sector

Applicant 1 Past Employer Company Name

Applicant 1 Past Employer Company Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 1 Past Occupation Role

Applicant 1 Past Employer Contact Name

Applicant 1 Past Employer Contact No.

Applicant 1 Self Employed

Applicant 1 – Self Employed Applicant(s)

Applicant 1 Business Name

Applicant 1 Type of Entity

Applicant 1 Company Website / URL

Applicant 1 ABN/ACN

Applicant 1 Industry

Applicant 1 Are You a Director?

Applicant 1 What is your ownership percentage in the business?

(%)

Applicant 1 Has your ownership percentage in the business changed over the last 24 months

Applicant 1 Please explain why the ownership percentage has changed over the last 24months *

Applicant 1 Net Profit Current FY ($)

Applicant 1 Net Profit Previous FY ($)

Applicant 1 Add Backs Current FY ($)

Applicant 1 Add Backs Previous FY ($)

Applicant 1 Was your business affected by the Covid pandemic?

Applicant 1 Has the business performance/operations returned back to normal?

Applicant 1 Please provide details of what has not returned back to normal: *

Applicant 1 Accountant Business Name

Applicant 1 Accountant Contact Name

Applicant 1 Accountant Contact No.

Applicant 1 Trustee (if applicable)

Applicant 1 Beneficiaries

Applicant 2 Type of Employment

Applicant 2 Start Date of Becoming Unemployed

Applicant 2 Employment Status

Applicant 2 Employment Sector

Applicant 2 Company Name

Applicant 2 Company Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 2 Occupation Role

Applicant 2 Start Date With Current Employer

Applicant 2 Employer Contact Name

Applicant 2 Employer Contact No.

Applicant 2 Income Details

Applicant 2 Base Salary ($)

Applicant 2 Income Frequency

Applicant 2 Regular Overtime ($)

Applicant 2 Regular Commission / Bonuses ($)

Applicant 2 Regular Motor Vehicle Allowance ($)

Applicant 2 Regular Allowances – Other ($)

Applicant 2 Please Specify Type of Regular Allowances

Applicant 2 Existing Income e.g. Share Dividends ($)

Applicant 2 Government Payment ($)

Applicant 2 Government Payment Type

Applicant 2 Please specify other type *

Applicant 2 If you have been in your current employment for less than 3 years, please enter your previous employment details up to 3 years below.

Applicant 2 Past Type of Employment

Applicant 2 Start Date of Becoming Unemployed in the Past

Applicant 2 Start Date with this Past Employer

Applicant 2 End Date with this Past Employer

Applicant 2 Past Employment Status

Applicant 2 Past Employment Sector

Applicant 2 Past Employer Company Name

Applicant 2 Past Employer Company Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Applicant 2 Past Occupation Role

Applicant 2 Past Employer Contact Name

Applicant 2 Past Employer Contact No.

Applicant 2 – Self Employed Applicant(s)

Applicant 2 Business Name

Applicant 2 Type of Entity

Applicant 2 Website / URL

Applicant 2 ABN/ACN

Applicant 2 Industry

Applicant 2 Are You a Director?

Applicant 2 What is your ownership percentage in the business?

(%)

Applicant 2 Has your ownership percentage in the business changed over the last 24 months

Applicant 2 Please explain why the ownership percentage has changed over the last 24months *

Applicant 2 Net Profit Current FY ($)

Applicant 2 Net Profit Previous FY ($)

Applicant 2 Add Backs Current FY ($)

Applicant 2 Add Backs Previous FY ($)

Applicant 2 Was your business affected by the Covid pandemic?

Applicant 2 Has the business performance/operations returned back to normal?

Applicant 2 Please provide details of what has not returned back to normal: *

Applicant 2 Accountant Business Name

Applicant 2 Accountant Contact Name

Applicant 2 Accountant Contact No.

Applicant 2 Trustee (if applicable)

Applicant 2 Beneficiaries

Applicant 1 – Have you ever had any default financial judgement or legal proceeding against you? *

Applicant 1 – Have you any difficulty meeting your financial commitments in the past 2 years? *

Applicant 1 – Are any of your existing debts currently in arrears? *

Applicant 1 – Do you expect any significant changes to your financial situation in the foreseeable future that would adversely impact your commitment? *

Applicant 1 – How you expect to meet your commitments? *

Applicant 1 – Please comment if you answered "Yes" to any of the above questions *

Applicant 2 – Have you ever had any default financial judgement or legal proceeding against you? *

Applicant 2 – Have you any difficulty meeting your financial commitments in the past 2 years? *

Applicant 2 – Are any of your existing debts currently in arrears? *

Applicant 2 – Do you expect any significant changes to your financial situation in the foreseeable future that would adversely impact your commitment? *

Applicant 2 – How you expect to meet your commitments? *

Applicant 2 – Please comment if you answered "Yes" to any of the above questions *

Properties

Property Type

Property Address

Property Monthly Rent ($)

If this is your own home then type “0”

Property Value ($)

Property Ownership

Vehicles

Vehicle Make/Brand

Vehicle Model

Vehicle Year Made

Vehicle Value ($)

Vehicle Ownership

Bank Accounts

Bank Name

Bank Account Type

Bank Acc No.

Bank Acc Value ($)

Bank Acc Ownership

Home Contents Details

Home Contents Value ($)

Home Contents Ownership

Share Investments – Institution

Share Investments Value ($)

Share Investments Ownership

Super Fund – Institution

Super Fund Value ($)

Super Fund Ownership

Other Assets

Other Assets Value ($)

Other Assets Ownership

Liabilities

Loan/Lender

Loan Account No.

Loan Interest Rate %

Loan Fixed Rate Expiry Date

Loan Ownership

Loan Limit ($)

Loan Balance ($)

Loan Repayment ($)

Loan Repayment Type

Loan Interest Only Expiry Date

Loan Expiry Date

Loan Clearing

Clearing?

Vehicle Loans

Vehicle Loan & Lender

Vehicle Loan Acc Number

Vehicle Loan Interest Rate (%)

Vehicle Loan Expiry Date

Vehicle Loan Ownership

Vehicle Loan Limit ($)

Vehicle Loan Balance ($)

Vehicle Loan Repayment ($)

Vehicle Loan Clearing

Clearing?

HELP / HECS Loans

HELP / HECS

HELP / HECS Ownership

HELP / HECS Balance ($)

HELP / HECS Repayment ($)

Conveyancing Firm / Solicitor Company

Conveyancer / Solicitor Contact Name

Conveyancer / Solicitor Contact Number

Conveyancer / Solicitor Email

1. Board – Current

1. Ongoing Post-Settlement

1. Post-Settlement

2. Childcare – Current

2. Ongoing Post-Settlement

2. Post-Settlement

3. Child Maintenance – Current

3. Ongoing Post-Settlement

3. Post-Settlement

4. Clothing & Personal Care – Current

4. Ongoing Post-Settlement

4. Post-Settlement

5. Entertainment – Current

5. Ongoing Post-Settlement

5. Post-Settlement

6. Groceries – Current

6. Ongoing Post-Settlement

6. Post-Settlement

7. Healthcare – Current

7. Ongoing Post-Settlement

7. Post-Settlement

8. Higher Education & Vocational Training – Current

8. Ongoing Post-Settlement

8. Post-Settlement

9. Home Maintenance – Current

9. Ongoing Post-Settlement

9. Post-Settlement

10. Investment Property Costs – Current

10. Ongoing Post-Settlement

10. Post-Settlement

11. Medical & Life Insurance – Current

11. Ongoing Post-Settlement

11. Post-Settlement

12. Other – Current

12. Ongoing Post-Settlement

12. Post-Settlement

13. Other Insurances – Current

13. Ongoing Post-Settlement

13. Post-Settlement

14. Pet Care – Current

14. Ongoing Post-Settlement

14. Post-Settlement

15. Private & Non-Government Education – Current

15. Ongoing Post-Settlement

15. Post-Settlement

16. Public Primary & Secondary Education – Current

16. Ongoing Post-Settlement

16. Post-Settlement

17. Electricity – Current

17. Ongoing Post-Settlement

17. Post-Settlement

18. Gas – Current

18. Ongoing Post-Settlement

18. Post-Settlement

19. Home & Contents Insurance – Current

19. Ongoing Post-Settlement

19. Post-Settlement

20. Vehicle Insurance – Current

20. Ongoing Post-Settlement

20. Post-Settlement

21. Rates & Water – Current

21. Ongoing Post-Settlement

21. Post-Settlement

22. Rental Expenses – Current

22. Ongoing Post-Settlement

22. Post-Settlement

23. Strata Fees & Land Tax – Current

23. Ongoing Post-Settlement

23. Post-Settlement

24. Telephone & Internet – Current

24. Ongoing Post-Settlement

24. Post-Settlement

25. Vehicle Maintenance & Transport – Current

25. Ongoing Post-Settlement

25. Post-Settlement

PRIVACY DISCLOSURE STATEMENT & CONSENT

We are collecting personal and financial information about you to provide you with our broking services.
1. The information you provide will be held by us and Finsure Finance and Insurance (Australian Credit Licence 384704).
2. You appoint us as your agent to obtain your credit information from a credit reporting body on your behalf.
3. You appoint us, our employees and our agents permission to contact your employer(s), accountant and superannuation provider or anyone else as required for the purpose of verifying details supplied by you.
4. We may use credit information and any other information you provide to arrange or provide finance and other services.
5. We may exchange the information with the following types of entities, some of which are located overseas:
• Persons who provide finance or other products to you, or to whom an application has been made for those products.
• Financial consultants, accountants, lawyers and advisers
• Any industry body, tribunal, court or otherwise in connection with any complaint regarding our services
• Any person where we are required by law to do so
• Any of our associates, related entities, contractors and outsourcing partners some of which are in the Philippines
• Your referees, such as your employer, to verify information you have provided
• Any person considering acquiring an interest in our business or asset
• Any organization providing online verification of your identity
6. You confirm that you are authorized to provide the personal details presented and consent to your information being checked with the document issuer or official record holder via third party systems for the purpose of confirming your identity.
7. You may gain access to the personal information that we hold about you by contacting us. A copy of our privacy policy can be obtained at www.finsure.com.au or by contacting us on 1300 769 415. Our privacy policy contains information about how you may access or seek correction of the information we hold about you, how we manage that information and our complaints process.

If you do not provide the information, we may be unable to assist in arranging finance or providing other services.

APPLICANT(S) EXECUTION

Declaration and Acknowledgment
• You confirm that all information in this document has been recorded correctly.
• You can confirm that you have been provided with a Credit Guide.
• You agree that we may collect and use your personal information as specified in the Disclosure Statement above.
• You acknowledge that you have been informed about your risk insurance options.

file_1661560733267

Financial Services Guide

What you need to know.

Introduction

All references in this Financial Services Guide (FSG) to ‘we’, ‘us’ or ‘our’ are references to Finsure Finance and

Insurance Pty Ltd (ABN 72 068 153 926) (Australian Credit Licence Number 38470) (Finsure)

Any financial services provided in accordance with this FSG will only relate to products distributed by Honey Insurance Pty Ltd (ABN 52 643 672 628 and AFSL 528244) (Honey Insurance) on behalf of the product issuer RACQ Insurance Limited (ABN 50 009 704 152) (AFSL 233082) (RACQ Insurance).

Distribution of this FSG has been authorised by Finsure, Honey Insurance and RACQ Insurance.

Who We Are

Honey Insurance Home, Contents and Landlord Insurance policies are promoted and distributed from time to time by Finsure as an authorised representative of Honey Insurance. Honey Home, Contents and Landlord Insurance policies are promoted and distributed by Honey Insurance and are issued by RACQ Insurance.

The Purpose of this Financial Services Guide

This FSG is designed to assist you in making an informed decision about the services we offer and can provide to you. The FSG contains important information about:

Who we are & who we act for The services we provide

How we and others are remunerated for the above services How complaints are dealt with

How we respect your privacy; and How to contact us

Other documents you may receive

If you decide to acquire a Honey Insurance product, you will also receive a Product Disclosure Statement (PDS) and any applicable Supplementary Product Disclosure Statement (SPDS). The PDS and SPDS explain the significant benefits and features of the insurance policy and the rights, terms and conditions attached to the policy. They are aimed at assisting you to compare insurance products so that you can make an informed decision about whether or not to acquire the product.

Honey Insurance will send insurance documents including this FSG and PDS or applicable SPDS to the email address you have supplied.

Authorised Financial Services

Finsure is authorised to provide general financial product advice in relation to Honey Insurance and arrange for the issue of Honey Insurance to clients. This means that Finsure represent and act for Honey Insurance, not for you. Honey Insurance is responsible for the financial services that will be provided by Finsure to you. RACQ Insurance is the issuer of Honey Insurance products. Honey Insurance and Finsure are distributors of Honey Insurance products.

In some cases, we may make a recommendation or give an opinion about a general insurance product. Before acting on any information or general advice we give you, you need to consider the appropriateness of that information or general advice with regard to your individual objectives, financial situation and needs.

How we are paid

If you take out a Honey Insurance product, Finsure will receive a commission which may be up to 14% of the annual premium for that Honey Insurance product. The commissions paid to Finsure are included as part of your premium. If a premium is not payable for a Honey Insurance product under the terms and conditions on which it is offered to you, Finsure will not receive a commission if you decide to take out the product. Finsure staff (including directors) are paid an annual salary, and may also receive bonuses, or other incentives based on their performance as measured across various attributes.

Referrals

Where you have been referred to Finsure by a third party and you decide to acquire a Honey Insurance product, we may pay the referrer. The payment amount depends on the specific arrangement entered into with that referrer. Any remuneration paid to third party referrers is not charged directly to you. If you would like more details how Finsure and / or our referrers are remunerated (including commission or other benefits that may be received), please contact us after you receive this document.

Compensation Arrangements

The Corporations Act 2001 (Cth) requires Australian Financial Services Licensees to have arrangements for compensating retail clients for losses they suffer as a result of a breach by the licensee or its representatives of Chapter 7 of this Act, unless an exemption applies.

Finsure is covered by Honey Insurance’s professional indemnity insurance that complies with the requirements of section 912B of the Corporations Act. This insurance covers us and our employees for claims made against us by clients as a result of the conduct of us and our employees in the provision of financial services. You do not have a direct right to claim under this insurance.

Complaints

Let us know about your complaint

If you have a complaint about your Honey Insurance product, please contact Honey Insurance who will work with you to resolve the matter.

Call 137 137
Email feedback@honeyinsurance.com
Web honeyinsurance.com/complaints-and-feedback
Reviewing your complaint

If your complaint is not resolved when you first contact Honey Insurance, it will be referred to Honey Insurance’s internal dispute resolution process where it will be reviewed by a manager. If you are still dissatisfied following the manager’s review, the matter will be referred to a Customer Relations Team
member with the appropriate experience, knowledge and authority to deal with the dispute and will make a
final decision. Honey Insurance’s final decision will be provided to you.

You can find further information on Honey Insurance’s complaints management policy by visiting
https://www.honeyinsurance.com/complaints-and-feedback/
Refer to external dispute resolution

If you are not happy with Honey Insurance’s decision or the handling of your complaint, you can access the External Dispute Resolution Scheme, managed by the Australian Financial Complaints Authority (AFCA).

AFCA’s role is to provide consumers (you) with free, fair and independent dispute resolution for complaints

relating to financial service providers.

AFCA deals with complaints that fall within their ‘Complaint Resolution Scheme Rules’ and will only consider your complaint after Honey Insurance have first had the opportunity to resolve your complaint through its internal dispute resolution process. To find out whether your dispute qualifies for AFCA, you may contact them by calling 1800 931 678, emailing info@afca.org.au or visiting www.afca.org.au

General Insurance Code of Practice

As the product issuer, RACQ Insurance is a signatory to the General Insurance Code of Practice 2020. The General Insurance Code of Practice sets standards for insurers and is designed to raise the standard of practice and service in the general insurance industry. You can obtain a copy of the Code by contacting us or from the Insurance Council of Australia by calling 1300 728 228 or visiting insurancecouncil.com.au.

Your Privacy

Finsure, Honey Insurance and RACQ Insurance will collect, hold, use and disclose your personal information in accordance with the Australian Privacy Act and the Australian Privacy Principles (APP). Finsure’s privacy policy is available at https://finsure.com.au/privacy-policy/, Honey Insurance’s privacy policy can be found at honeyinsurance.com/privacy and RACQ’s privacy policy is available at racq.com.au/privacy.

If you wish to make a complaint about the privacy of your personal information, please contact us. You may also make a complaint to the Office of the Australian Information Commissioner (OAIC) upon becoming aware of any privacy issue.

Finsure

You can contact Finsure by calling 1300 346 787 or by emailing enquiries@finsure.com.au

Honey Insurance

You can contact Honey Insurance by calling 137 137, visiting honeyinsurance.com, or emailing contact@honeyinsurance.com

RACQ Insurance

You can contact RACQ Insurance by calling 13 19 05 or visiting racq.com.au/

Agreement Checkbox *