Threadpay application form
Westgate Finance Pty Limited trading as Threadpay ABN 30 072 165 603
Applying as
*
Corporation/Trust
Sole Trader
Partnership
Type of Company/Trust
*
Private company
Public company
Trust
Name of company as registered with ASIC/Name of Trust
*
Trading name (if different to above)
Name of Trustee Company
*
Full registered name of the Partnership
Business Name
Place of business address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Registered address (if different to above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
ACN of Company / Trustee Company
*
ABN
*
Bank account details
*
Name
BSB
Account number
Name of authorised representative
*
First Name
Middle Name
Last Name
E-mail of authorised representative
*
Phone number of authorised representative
-
Area Code
Phone Number
Mobile phone number of authorised representative
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Stakeholder Details
Director 1
First Name
Middle Name
Last Name
Director 2
First Name
Middle Name
Last Name
Director 3
First Name
Middle Name
Last Name
Director 4
First Name
Middle Name
Last Name
Which other stakeholder from the list below relates to your business?
Shareholder with 25% or greater ultimate ownership
Trustee
Partner
Sole trader
Other stakeholder name
*
First Name
Middle Name
Last Name
Other stakeholder Date of Birth
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
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25
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29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
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2009
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1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Other stakeholder residential address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Other stakeholder verification document
*
Australian driver licence
Australian passport
Other stakeholder driver licence or passport number
*
State of registration
*
NSW
ACT
QLD
NT
SA
WA
TAS
VIC
Passport expiry date
*
-
Month
-
Day
Year
Date
I confirm that I am authorised to provide the personal details presented and I consent to my information being checked with the document issuer or official record holder via third party systems for the purpose of confirming my identity
Yes
No
Is there a 2nd partner, trustee or beneficiary with 25% or greater ultimate ownership?
Yes
No
Which other stakeholder from the list below relates to your business?
Shareholder with 25% or greater ultimate ownership
Trustee
Partner
Other stakeholder name
*
First Name
Middle Name
Last Name
Other stakeholder Date of Birth
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
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1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Other stakeholder residential address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Other stakeholder verification document
*
Australian driver licence
Australian passport
Other stakeholder driver licence or passport number
*
State of registration
*
NSW
ACT
QLD
NT
SA
WA
TAS
VIC
Passport expiry date
*
-
Month
-
Day
Year
Date
I confirm that I am authorised to provide the personal details presented and I consent to my information being checked with the document issuer or official record holder via third party systems for the purpose of confirming my identity
Yes
No
Is there a 3rd partner, trustee or beneficiary with 25% or greater ultimate ownership?
Yes
No
Which other stakeholder from the list below relates to your business?
Shareholder with 25% or greater ultimate ownership
Trustee
Partner
Other stakeholder name
*
First Name
Middle Name
Last Name
Other stakeholder Date of Birth
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Other stakeholder residential address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Other stakeholder verification document
*
Australian driver licence
Australian passport
Other stakeholder driver licence or passport number
*
State of registration
*
NSW
ACT
QLD
NT
SA
WA
TAS
VIC
Passport expiry date
*
-
Month
-
Day
Year
Date
I confirm that I am authorised to provide the personal details presented and I consent to my information being checked with the document issuer or official record holder via third party systems for the purpose of confirming my identity
Yes
No
Is there a 4th partner, trustee or beneficiary with 25% or greater ultimate ownership?
Yes
No
Which other stakeholder from the list below relates to your business?
Shareholder with 25% or greater ultimate ownership
Trustee
Partner
Other stakeholder name
*
First Name
Middle Name
Last Name
Other stakeholder Date of Birth
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Other stakeholder residential address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Other stakeholder verification document
*
Australian driver licence
Australian passport
Other stakeholder driver licence or passport number
*
State of registration
*
NSW
ACT
QLD
NT
SA
WA
TAS
VIC
Passport expiry date
*
-
Month
-
Day
Year
Date
I confirm that I am authorised to provide the personal details presented and I consent to my information being checked with the document issuer or official record holder via third party systems for the purpose of confirming my identity
Yes
No
Please provide the details of any other person who ultimately owns or controls, directly or indirectly, the business
In the case of a trust, please provide the details of any other person who has the power to appoint/remove trustees?
Please provide details of any associate of the business that is a Politically Exposed Person (PEP)
This includes individuals who hold prominent public positions or functions in a government body or international organisation and individuals who are immediate family members or individuals who have close associations with such persons
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Supporting documents to upload
The first page of a recent bank statement (within the last 6 months) showing bank account details that match those provided above
Upload a File
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For a trust: A certified copy of a Trust Deed
Upload a File
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Payment details
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Declaration
I declare that the information contained in this application is true and correct in every particular and is the basis on which I make this application. I declare I have the authority to make this application on behalf of the applicant and bind it to the terms and conditions below.
*
Yes
No
Please note that you will only be able to tick the box below once you have read to the bottom of the terms & conditions
*
Authorised Signatory name
First Name
Last Name
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