Logan East Community Neighbourhood Association Cnr Cinderella Dr and Vanessa Blvd

PO Box 1230 Springwood Q 4127 PH: 07 3808 4529

Email: nils@lecna.org.au

A community Initiative for people……. not for profit.

Thank you for your enquiry

No Interest Loans (NILS) provide individuals and families on low incomes with access to safe, fair and affordable credit. Loans are available for essential goods and services such as fridges, washing machines, car repairs and medical procedures for up to $1,500. Repayments are set at an affordable amount over 12 to 18 months.

Eligibility Requirements

• Health Care Card / Pension Card or earn less than $45,000 a year after tax ($60,000 for couples or people withdependants)

• current or previous address for at least 3 months• Capacity to repay the loan

Application Process Check you meet the requirements

1. Review attached checklist

2. Send in your supporting documents with your contact details listed (Please send multiple emails if the file size is greater

than 20MB) or an alternative by Australia Post to our PO BOX listed above.

3. You will receive a phone call to arrange an appointment time for your interview.

4. During the interview, the Microfinance worker will ensure the loan is affordable and all Supporting documents provided.

5. Loan application will be submitted to loans Assessor for review

6. You will be notified of the decision.

*please note when providing a quote for the electrical items – we have a working relationship with the good guys where wereceive free delivery on fridges & washing machines as well as received a commercial discount

If you need assisting with obtaining a quote, please let us know the made and model number and we can compare.

Kind Regards NILS

Logan East Community Centre Cnr Cinderella Drive & Vanessa Blvd PO Box 1230 Springwood 4127 T: 07 3808 4529 || M: 0491 735 492/ 0490 743 160

E: Nils@lecna.org.au | W: www.lecna.org.au

Logan East No Interest Loan Scheme (NILS)

Supporting Document Checklist

Email to nils@lecna.org.au

PO BOX 1230 Springwood Qld 4127

CRN Cinderella Drive & Vanessa Blvd,Springwood

Call 07 3808 4529

Text : 0491 735 492 (Client support provider ) Text : 0490 743 160 (Loan provider)

IDENTIFICATION

Drivers licence

Centrelink Health Care card

or Pension card

INCOME

Centrelink Income Statement

(less than two weeks old)

Payslips

(last two with employer’s ABN)

PLACE OF RESIDENCE

Renting

Rental statement showing over 3

months stay and that rent is up to

date

Not on a Lease or Boarding

Please provide a statutory Declaration

from your landlord or main

leaseholder

Homeowner

Most Recent Property rate notice

Quote

Quote must be on official letterhead

with ABN & Bank Details/or screen

shot of online items, including

purchase price including GST &

delivery costs if applicable

BILLS

Bring the most recent bill even if the account

is being direct debited from Centrelink or a

bank account

Gas

Electricity

Telephone /Internet/Mobile

FINANCIAL STATEMENTS

Covering the last 90 days

All bank accounts

All credit cards

All loans

Eg Payday loans, personal loans, car loans

ANY OTHER DEBTS

Recent statement

Bond loans

Centrelink debt

(Centrelink deduction statement)

Fines

Rent to buy contracts

Other debts

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NILS ENQUIRY OR NEW APPLICATION FORM DATE:

ORGANISATION: NILS WORKER: *= Compulsory; Ɨ = Refer to Appendix for a description and/or a defined of list options.

ENQUIRY METHOD Enquiry Method* ☐In person ☐Phone ☐ Email ☐SMS ☐ Other

PERSONAL DETAILS – APPLICANT 1 First name*

Middle name

Last name*

Pref name

Date of birth*

ENQUIRY OR NEW APPLICATION Loan purpose(s)* Ɨ

Loan sub purpose(s)* Ɨ

Loan amount ($)*

Loan period (months)

Fortnightly repayment ($)

How heard about NILS? Ɨ

Eligibility criteria* ☐ Earns less than $45,000 per year after tax

☐ Centrelink benefit

☐ Health Care card

Time at current address* ☐ 0 – 3 months ☐ 3 – 6 months ☐ 6+ months

Time at previous address ☐ 0 – 3 months ☐ 3 – 6 months ☐ 6+ months

If less than 3 months for current AND previous address provide reasons

Show Client Rights and Responsibilities handout.

Residential address (& postal if different)*

Suburb*

Post code* State*

Accommodation type* Ɨ Private/Public/Boarding/Own Home/Temporary house /Other Living arrangements* Ɨ Single/Single+kids/Couple/Couple+kids/Related family/group non family Number of dependants*

Email

Phone no.*

Client explanation – sensitive questions.

Country of birth* Language at home*

Gender* ☐ M ☐ F ☐ Intersex ☐ Indeterminate ☐ Not stated or inadequately described

Circumstances/concerns* Ɨ

Identifies as Australian Indigenous?* ☐ YES. Status?*Ɨ: ☐ NO ☐ Prefer not to answer

Identifies with having a disability?* ☐ YES. Nature?*Ɨ: ☐ NO ☒ Prefer not to answer

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SECONDARY CONTACT Explain the need for an additional contact person

First name

Last name

Email

Phone no.

Relationship

Joint application? If a second person is added, the clients will need to supply supporting documentation for both applicants.

JOINT APPLICATION: PERSONAL DETAILS – APPLICANT 2 First name*

Middle name

Last name*

Date of Birth*

Address (if different) *

Suburb

Post code

State

Email

Phone no.

LOAN DETAILS CONTINUED Loan period (months)

Fortnightly repayment ($)

Explain that the loan application will be submitted to a different person in your organization or another organisation to be assessed. If sending to another organisation, explain to the client that they will need to enter into a loan agreement with that organisation and that if approved, that organisation will manage their repayments.

Chosen Loan Provider*

Explain the quote process – if the client does not yet have a quote for their item(s), explain one is needed to complete the application. The Good Guys - Good2GoNow website: https://www.thegoodguyscommercial.com.au

Quote reference

CENTRELINK INFORMATION AUTHORITY – CCeS FORM

Need assistance to access Centrelink information?*: ☐ Yes ☐ No

BUDGET SUMMARY Explain the budget process, and complete and attach the budget form along with all supporting documents.

REPAYMENT Repayment method ☐ Centrelink payments (record details below) ☐ Direct deposit

CRN* Benefit used*

Repayment frequency*

Expected loan

start date*

CENTREPAY DEDUCTION AUTHORITY If paying by CentrePay, ask the client to read and verbally agree to the CentrePay Verbal Authority (CVA) script Ɨ

Authority given by*: ☐ Phone ☐ In person

Client agrees to the CVA terms*? ☐ Yes ☐ No (if no, cannot proceed)

Date & time of verbal agreement*

CONDITIONAL LOAN AGREEMENT, INSURANCE & NEXT STEPS Explain to the client that the next step is to prepare a Conditional Loan Agreement. Attach once read and signed.

Explain insurance option to the client. Discussed insurance with client*? ☐ Yes ☐ No

Explain the next steps to the client.

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NILS APPLICATION BUDGET FORM CLIENT NAME: BUDGET – INCOME (FORTNIGHTLY)

Income type Amount ($) Notes

Centrelink:

Wages

Other (specify)

Income total

BUDGET – EXPENSES (FORTNIGHTLY) Item Amount ($) Notes Item Amount ($) Notes

HOUSING PERSONAL continued

Rent/board Alcohol

Rental arrears Casino/pokies etc

Mortgage Gifts

House/contents insurance

Child support

Home repairs Gym membership

Council rates/strata fees Other:

Furniture storage SAVINGS / INSURANCE

Other: Savings/Christmas clubs

FOOD / GROCERY Funeral plan

Supermarket Life/unemployment insurance

Butcher and grocer Other:

Takeaway/snacks etc BILLS / UTILITY

Pets/pet related Gas

Laundry/cleaning Electricity

Other: Water

PERSONAL Home phone/internet

Clothing/shoes Mobile

Haircuts Pay TV/Netflix/Stan

Entertainment/movies Utility arrears

Childcare/afterschool Other:

Newspapers/mags etc

Smoking

Baby needs

ADDITIONAL BUDGET NOTES

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BUDGET – EXPENSES (FORTNIGHTLY) CONTINUED Item Amount ($) Notes Item Amount ($) Notes

HEALTH FINES / DEBTS

Doctor Traffic fines

Medicine Centrelink debt

Ambulance Taxation debt

Vitamins/supplements Other:

Dentist EXISTING LOANS

Health insurance Car loan

Optometrist Centrelink advance

Alt therapies/chiro etc Credit card

Other: Overdraft

TRANSPORT Bank loan

Public transport Payday loans

Petrol Rent to buy

Car registration Store accounts/layby

Car repairs/servicing Family/friends

Car insurance Other:

Taxi/ride share NILS REPAYMENT

Other:

EDUCATION

School/course fees etc

Uniform

Bags/stationery

Excursions/camps TOTAL INCOME

Sports/club membership

TOTAL EXPENSES

Other: FORTNIGHTLY SURPLUS (INCOME – EXPENSES)

Are the income & expenses included in this budget for a single person or a couple? ☐ Single ☐ Couple

ADDITIONAL BUDGET NOTES

ADDITIONAL APPLICATION NOTES

No Interest Loan Scheme (NILS) Client Agreement This agreement will be included in your application for a NILS loan when it is submitted for a loan assessment. It outlines (1) our promise to protect your personal information and (2) your responsibilities as a NILS loan client if your loan is approved.

Client/s name:___________________________________________________________________

Client/s address:__________________________________________________________________

Our responsibilities to you

Good Shepherd Microfinance is a not-for-profit organisation that provides access to the NILS program in partnership with local community organisations across Australia.

The information in your loan application will be submitted to Logan East for a loan assessment. The information is securely held in a protected database owned by Good Shepherd Microfinance. Your information is collected solely for the purposes of assessing and managing your loan. Other NILS providers will be able to see a record of your loan only (name, date of birth and loan status, but no other personal information). Your name and personal information will not be shared or used to encourage you to purchase other products and services. From time to time, Good Shepherd Microfinance reports de-identified (a process used to prevent a person's identity from being connected with information) data to the major partners of the NILS program: the Australian Government, State governments and National Australia Bank. The reporting does not contain any information about your personal identity. We promise your name and personal information will remain private.

As a NILS client, you’re entitled to ask for a copy of your personal information at any time. You can read the NILS Privacy Policy at www.nils.com.au/privacy

Your responsibilities

I, ____________________________, have applied for a NILS loan through Logan East.

By signing this agreement, I am confirming that all the information I have given is true and correct to the best of my knowledge.

If my loan is approved, I promise to repay Logan East a total of $______ or a lower amount as agreed with Logan East. I will repay $______ a fortnight starting on __/___/____ until the loan has been fully repaid.

I will contact Logan East if my personal contact details change.

I will contact Logan East to discuss my options if I have any problems making repayments.

I agree that Good Shepherd Microfinance can contact me:

To talk about my loan To give me information about NILS To invite me to participate in future research (such as surveys or workshops) to help

improve NILS (optional – tick to opt in) I understand that when I repay my loan, more people in the community will be able to access a NILS loan.

Name of Client 1: ______________________________________

Signature: ____________________________________________

Date: ___/___/_____

Name of Client 2 (if applicable): ___________________________

Signature: ____________________________________________

Date: ___/___/_____

Name of witness or person supporting the client to apply:

_____________________________________________________

Signature: ____________________________________________

Date: ___/___/_____

No Interest Loan Scheme Client Charter This Client Charter provides an outline of the level of service individuals can expect when getting a NILS loan through a local community provider.

What you can expect from us

1. Your loan application will be processed as soon as possible. 2. You will be treated fairly and with respect. 3. You will receive services in a fair and supportive way. 4. We will explain the loan process in simple terms. 5. You will be informed about how your personal information is used. 6. We respect your privacy, your name and personal information will be kept private. 7. We will refer you to financial counselling if you need further support. 8. We will work with you if you experience hardship and have difficulties repaying the loan.

How you can assist us

1. Be honest to help us understand your needs so that we can give you the best possible service.

2. Tell us if your personal details change in a timely way so that we can contact you when we need to.

3. Tell us how we are doing and give us feedback on our service. 4. Act in a manner that respects our employees and volunteers. 5. Make sure the information you provide us is correct. 6. Make regular repayments on your loan as per your agreement. 7. Contact us if you get into financial difficulty and work with us to make suitable arrangements. 8. Spread the word about NILS, so that more people know about safe, fair and affordable

finance.

NILS Centrepay written consent Client name: _____________________________________________________________________

Client CRN: _______________________________________________________________________

Client Date of Birth: ________________________________________________________________

I understand that the information in this application, and the consent for Centrepay deductions is being prepared by _______________________________Logan East, and will be submitted to ______________________ Logan East. Good Shepherd Microfinance will also have access to the information in my application and my Centrepay consent record. I authorise the Department of Human Services to deduct __$________________ each fortnight from my __________________________________________ Centrelink benefit and pay this amount to _____________________________________ Logan East for my NILS loan commencing from my next available payment date. I give permission for Logan Eastto disclose my information to the Department of Human Services for the purposes of checking my account number, billing number, and the amount I want to pay, and reconciling my payment Deduction details. I give my consent for Logan East to give my correct account and billing number to the Department of Human Services if required. I give permission for the Department of Human Services to disclose my information to Logan East and Good Shepherd Microfinance for the purposes of checking my account number, billing number and amount I want to pay, and reconciling my payment Deduction details. I understand and agree that:

• It is my choice to have this amount deducted from my Centrelink payments, and I can change or cancel the Deduction at any time by contacting the Department of Human Services or Logan East

• The target amount for my Deduction is _________________________ • My deductions will start at my next available payment date. • If my Deduction has a target amount and the final Deduction is set to pay less than $2, my second

last Deduction will be increased by up to $2 to cover the final amount • If I have a current Centrepay Deduction and I transfer to another eligible Centrelink payment in the

future, my Deductions may continue • My Deduction Authority consent will be noted on my account record with Logan East • Further information can be found online at humanservices.gov.au/centrepay

Client signature: ________________________________ Date: ________________________________

MFW-001 Statutory Declaration Tenancy as at October 2015

Commonwealth of Australia

STATUTORY DECLARATION

Statutory Declarations Act 1959 (1) Insert the name

and address of person making the declaration

1 I, __________________________________________________ (full name of the home owner,

landlord or person listed on the lease)

Of (full address)__________________________________________________________________

_______________________________________________________________________________

make the following declaration under the Statutory Declarations Act 1959:

(2) Set out matter

declared to filling in all of the blanks.

2 Declare that (full name of Nils applicant)___________________________________________

is a tenant or boarder of mine and resides at:

(full address) ____________________________________________________________________

_______________________________________________________________________________

I receive $___________ per week / fortnight / month (circle relevant frequency). This includes rent / utilities / food (circle as required). Rent/board has been paid up to __________________ (date) The tenant or boarder has been residing at this address for ______ years _____ months. I understand that a person who intentionally makes a false statement in a statutory declaration is guilty of an offence and I believe that the statements in this declaration are true in every particular.

Note 1 A person who intentionally makes a false statement in a statutory declaration is guilty of an offence, the punishment

for which is imprisonment for a term of 4 years — see section 11 of the Statutory Declarations Act 1959.

Note 2 Chapter 2 of the Criminal Code applies to all offences against the Statutory Declarations Act 1959 — see section 5A

of the Statutory Declarations Act 1959.

3 Signature of

person making the declaration

3 X______________________________

(Declarant’s signature. Must be signed in front of an approved witness e.g. teacher, pharmacist, doctor or Justice of the Peace. See 2nd page for a list)

4 Place 5 Day 6 Month and year

Declared at 4 _________________________ on 5 _____________ of 6 ___________________

7 Signature of person before whom the declaration is made (see over)

Before me, 7 X_______________________________ (Signature of witness)

8 Full name, qualification and address of person

before whom the declaration is made (in printed letters)

8

MFW-001 Statutory Declaration Tenancy as at October 2015

A statutory declaration under the Statutory Declarations Act 1959 may be made before–

(1) a person who is currently licensed or registered under a law to practise in one of the following occupations:

Chiropractor Dentist Legal practitioner

Medical practitioner Nurse Optometrist

Patent attorney Pharmacist Physiotherapist

Psychologist Trade marks attorney Veterinary surgeon

(2) a person who is enrolled on the roll of the Supreme Court of a State or Territory, or the High Court of Australia, as a legal practitioner (however described); or

(3) a person who is in the following list:

Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public

Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955)

Bailiff

Bank officer with 5 or more continuous years of service

Building society officer with 5 or more years of continuous service

Chief executive officer of a Commonwealth court

Clerk of a court

Commissioner for Affidavits

Commissioner for Declarations

Credit union officer with 5 or more years of continuous service

Employee of the Australian Trade Commission who is:

(a) in a country or place outside Australia; and

(b) authorised under paragraph 3 (d) of the Consular Fees Act 1955; and

(c) exercising his or her function in that place

Employee of the Commonwealth who is:

(a) in a country or place outside Australia; and

(b) authorised under paragraph 3 (c) of the Consular Fees Act 1955; and

(c) exercising his or her function in that place

Fellow of the National Tax Accountants’ Association

Finance company officer with 5 or more years of continuous service

Holder of a statutory office not specified in another item in this list

Judge of a court

Justice of the Peace

Magistrate

Marriage celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961

Master of a court

Member of Chartered Secretaries Australia

Member of Engineers Australia, other than at the grade of student

Member of the Association of Taxation and Management Accountants

Member of the Australasian Institute of Mining and Metallurgy

Member of the Australian Defence Force who is:

(a) an officer; or

(b) a non-commissioned officer within the meaning of the Defence Force Discipline Act 1982 with 5 or more years of continuous service; or

(c) a warrant officer within the meaning of that Act

Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants

Member of:

(a) the Parliament of the Commonwealth; or

(b) the Parliament of a State; or

(c) a Territory legislature; or

(d) a local government authority of a State or Territory

Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961

Notary public

Permanent employee of the Australian Postal Corporation with 5 or more years of continuous service who is employed in an office supplying postal services to the public

Permanent employee of:

(a) the Commonwealth or a Commonwealth authority; or

(b) a State or Territory or a State or Territory authority; or

(c) a local government authority;

with 5 or more years of continuous service who is not specified in another item in this list

Person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made

Police officer

Registrar, or Deputy Registrar, of a court

Senior Executive Service employee of:

(a) the Commonwealth or a Commonwealth authority; or

(b) a State or Territory or a State or Territory authority

Sheriff

Sheriff’s officer

Teacher employed on a full-time basis at a school or tertiary education institution