Broker Application for Accreditation

Broker Application for Accreditation
Accreditation Checklist – New Accreditation Requirements*

Complete and sign this Application for Accreditation form.Attach a legible copy of your current Australian Driver’s Licence or passport.Attach a copy of your Statement of Attainment & Membership certificate for either Certified Credit Adviser/Credit Advisor/Associate Credit Advisor/Accredited Mortgage Consultant from the MFAA or for either Accredited Member/Associate Member from the FBAA.Attach a certificate of currency for your Professional Indemnity Insurance. If the PI insurance is in the company name, a Letter from a Director of the company confirming the applicant is covered under the company’s PI must also be provided. The total sum insured is to be a minimum of $2,000,000 in any one claim and $4,000,000 in the aggregate, and have an excess per claim of no greater than $5,000.Provide a copy of your membership certificate with an ASIC approved External Dispute Resolution Scheme (FOS/CIO/AFCA).
Name as per photo identification*

MrsMsMissOthers:
Name*

First NameMiddle NameLast Name
Preferred Name (if applicable)
Email Address*
example@example.com
Residential Address (PO Box in not acceptable)*
Driver License/Passport Number*
Driver License/Passport Expiry Date*

MonthDayYear
Date
Date of Birth*

MonthDayYear
Date

Licensing/Registration Details

Please select from the 3 options and provide details
*

I am a Credit Representative (CR) of a holder of an Australian Credit Licence (ACL)
ACL Registered Name*
ACL Number*
Full Name*
CR Number*
*

I have been issued with an ACL
ACL Registered Name*
ACL Number*
*

I am an employee/director of a holder of an ACL (please circle)
ACL Registered Name*
ACL Number*
Broker Business Details
Broker Business Details*

Aggregation GroupBusiness/Broker Group NameNumber of Brokers in Group
Business/Company Address*
Business/Company Mailing Address (if different from above)
Business Phone Number*
Format: (000) 000-0000.
Business Fax Name
Business Mobile Number*
Format: (000) 000-0000.
Primary Business Activity (e.g: solicitor, accountant, mortgage broker)*

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