Consumer Loan and Overdraft Application Form Dnister Ukrainian Credit Co-operative

Consumer Loan and Overdraft Application Form Dnister Ukrainian Credit Co-operative Dnister Ukrainian Credit Co-operative Head Office : 912 Mt Alexander Road (PO Box 279) Essendon VIC 3040 (03) 9375 1222 Adelaide Branch : 62 Orsmond Street (PO Box 260) Hindmarsh SA 5007 (08) 8346 6174 Geelong Branch : 3/29-35 Milton Street Bell Park VIC 3215 (03) 5278 5950 Perth Agency : PO Box 154 Maylands WA 6051 loans@dnister.com.au Page 1 of 13

Consumer Loan and Overdraft Application Form PART 1 - Details Applicant (1) Guarantor (1) Member Number Applicant (2) Guarantor (2) Member Number Full Name Full Name Do you wish to combine an existing loan? PART 2 - New Loan Purpose What is the purpose of the loan and what are your requirements and / or objectives? Please indicate the intended purpose of the loan : Amount required : Comments: Purchase or refinance home (owner occupied) Construct home (owner occupied) Home improvements (owner occupied) Purchase or refinance home (investment property) Construct home (investment property) Home improvements (investment property) Motor Vehicle purchase Debt consolidation - loans and/or credit cards Commercial / Business purposes - ie. Share investments TOTAL LOAN AMOUNT 0.00 Loan Term years PART 3 - Checklist Evidence of income For full time, part time and casual employees, your two most recent payslips For all other income, e.g. dividends, your most recent Tax Return and tice of Assessment For rental income, evidence by way of lease agreement or Real Estate ment For self-employed applicants, your financial statements, Tax Returns and tices of Assessment for the 2 most recent financial years Evidence of assets and liabilities Your most recent rates notice for property that you own detailing the capital improved value Your previous six months transaction account statements (for accounts not held with Dnister) Details of your personal/home/vehicle insurance Details of your superannuation If refinancing from another financial institution, a minimum of your previous six months loan transaction statements. Your most recent credit/store card statements If purchasing a property Copy of Contract of Sale for the property For constructions Complete Part 7 of this application Page 2 of 13

PART 2 - applicant or guarantor personal details Applicant personal details Applicant personal details Full Name Full Name Date of Birth (DD/MM/YYYY) / / Country of Birth Male Female Date of Birth (DD/MM/YYYY) / / Country of Birth Male Female Mother's maiden name Mother's maiden name Driver's licence number Driver's licence number Home Phone Number Work Phone Number Home Phone Number Work Phone Number Mobile Number Fax Number Mobile Number Fax Number Email address @ Email address @ Current residential address Current residential address Unit Number Street Number Unit Number Street Number of years at current residential address years of years at current residential address years Mailing Mailing As above OR As above OR Previous Residential es ( if less than 3 years at current address) Previous Residential ( if less than 3 years at current address) Unit Number Street Number Unit Number Street Number Residential Status Residential Status Owner Renting Boarding Paying Mortgage Owner Renting Boarding Paying Mortgage Unit Number Street Number Unit Number Street Number Residential Status Residential Status Owner Renting Boarding Paying Mortgage Owner Renting Boarding Paying Mortgage Page 3 of 13

PART 3 - Loan Type Please select your Loan Type Premier Home Loan Standard Variable Home Loan Premier Personal Loan (Secured) Personal Loan (Unsecured) Interest Only Loan Equity Access Facility Personal Overdraft P Please attach the overdraft facility to : Account : SAV PART 4 - Employment and Marital Status Marital Status Please select your Loan Features P P P Variable Interest Rate Fixed Term 100% Offset Account Redraw Facility Redraw Facility CueCard / Eftpos Facility Cheque Book Facility Marital Status 1 year 2 years 3 years 4 years 5 years te : If internet banking redraws ARE NOT required, please complete a Redraw Facility Authority Form to disable the service. Married De facto Single Married De facto Single Employment Employment Salary Student Social Benefits Salary Student Social Benefits Self-employed Unemployed Home Duties Employment Category Full-time Part-time Casual/Temp Employer Self-employed Unemployed Home Duties Employment Category Full-time Part-time Casual/Temp Employer Position Position Industry Industry Employer Employer Phone Number Phone Number Number of years with current employer Number of years with current employer If less than 3 years at current employer, details of previous employer I understand that Dnister is required to confirm my employment details, accordingly I give my permission. Previous Employment Previous Employer If less than 3 years at current employer, details of previous employer I understand that Dnister is required to confirm my employment details, accordingly I give my permission. Previous Employment Previous Employer Previous Position Previous Position Previous Industry Previous Industry Previous Employer Previous Employer Phone Number Phone Number Page 4 of 13

PART 5.1 - Assets (What you own) Home and Investment Properties Owner Present Value() Motor Vehicle(s) Registered to Make / Model / Year Present Value() Savings Account Owner Financial Institution Current Balance() Assets Owner Description Present Value() TOTAL (ASSETS) VALUE OF WHAT YOU OWN (A) 0.00 Sundry Assets (not be included in above Asset Table) Home Contents (Insured value) Superannuation (Estimated current payout) Goodwill of Business (Estimated value) PART 5.2 - Liabilities (What you owe) Home and Investment Loan(s) Borrower(s) Financial institution and type of loan Current Owing () Credit / Store Cards Borrower(s) Financial Institution and type of card Limit Personal Loans or other debts and liabilities Borrower(s) Debt or loan detail(s) including Financial institution if applicable TOTAL (LIABILITIES) VALUE OF WHAT YOU OWE (B) 0.00 NET ASSETS (A) - (B) 0.00 Page 5 of 13

PART 6 - Security PROPERTY Please provide details of security offered (attach purchase contract if applicable and details of solicitor handling the purchase) Property (1) Owner(s) Property (2) Owner(s) Occupants of property (1) Estimated security value () Occupants of property (2) Estimated security value () Self Tenants Self Tenants Property (3) Owner(s) Property (4) Owner(s) Occupants of property (3) Estimated security value () Occupants of property (4) Estimated security value () Self Tenants Self Tenants Solicitor's / Conveyancer's details (where applicable) Name of Firm Contact name Telephone Fax Email @ If you intend to offer a motor vehicle as security for a loan, it is important that you provide the following details. You will also need to provide a copy of the current insurance policy and proof of ownership. MOTOR VEHICLE (1) MOTOR VEHICLE (2) Make Model Year Make Model Year Registration Engine Registration Engine Vin OTHER SECURITY Purchase Price Vin Purchase Price PART 7 - Constructions Only complete this section if this application is for constructions. Construction Estimated Completion Date / / New Home Home Extension Total Cost of Construction The following documents are required for construction of a new house and may be required for a home extension: Registered builder Plans and specifications (building permit, council approval plans) Signed fixed price building contract Copy of builders insurance - to be provided prior to funding Owner builder / subcontractor Plans and specifications (building permit, council approval plans) Building and indemnity insurance Quotations and estimates Work timing schedule Soil test and quantity survey Expenditure budget Page 6 of 13

PART 8 - Monthly Budget INCOME (A) - MONTHLY Monthly NET Salary Applicant or Guarantor (1) Applicant or Guarantor (2) REPAYMENTS / EXPENSE (B) - MONTHLY Current Home / Investment monthly repayment This column is used to calculate your new monthly expenses post funding of your loan. New* monthly repayment Current monthly rental income Gross Monthly Less Monthly Expenses Net Rental Income Credit / Store cards Proposed rental income Less Monthly Expenses Net Rental Income debts income (i.e. dividends, interest, govt, allowances) TOTAL (A) 0.00 TOTAL (B) 0.00 0.00 PART 9 - Funding Table EXPENSES (C) - MONTHLY TO BE COMPLETED BY DNISTER Estimated Funds Required Purchase, Contract Price or Estimate Monthly Rent School Fees / Childcare Insurance House / Contents Payout other Loans (inc. all payout fees) Insurance Vehicle(s) LMI Premium (if applicable) Health Insurance Your Legal Costs (e.g. your solicitor fees)* Telecommunication / internet Costs (e.g. rates, CCI insurance) TOTAL FUNDS REQUIRED (A) 0.00 Utilities (Gas, Electricity) Groceries Entertainment Funds in Hand This Loan Amount Net Proceeds from Previous Settlement Cash / Savings Deposit Paid TOTAL (C) 0.00 0.00 Govt. Assistance (eg FHOG) (e.g. gift) TOTAL FUNDS AVAILABLE (B) 0.00 TOTAL USABLE FUNDS = A - ( B + C ) TOTAL (A) minus 0.00 0.00 SURPLUS FUNDS (B minus A) 0.00 TOTAL (B) plus 0.00 TOTAL (C) 0.00 0.00 0.00 * As a guide, adopt 5% of purchase price TOTAL USABLE FUNDS 0.00 0.00 Page 7 of 13

PART 10 - Repayment Options Please indicate which method you would like to use to make your loan repayments : Payroll deduction Periodical payment from my Dnister account - SAV Monthly Periodical payment start date : Fortnightly Weekly PART 11 - mination to Receive tices (insert full name of borrower) is nominated to receive notices and other documents under the National Credit Code on behalf of me/all of us. If you do not wish to nominate please leave blank. IMPORTANT: Each debtor/mortgagor/guarantor is entitled to receive a copy of any notice or other document under the National Credit Code. By signing this form, you are giving up the right to be provided with information direct from Dnister Ukrainian Credit Co-operative. Any person who has signed this application can advise Dnister at any time in writing that they wish to cancel any nomination provided. PART 12 - Credit Protection and General Insurance Credit Protection Insurance and Disclaimer (Click here for QBE website link.) We offer full loan protection cover for all loan types. For an affordable amount added to your monthly repayment, you can be protected for Death, Disability (or Accident & Sickness) and Involuntary Unemployment or a combination of the three., we would like more information on Loan Protection cover, and understand, acknowledge and declare that if we decide not to proceed that;, we would not like to take advantage of Loan Protection cover and we acknowledge and declare that; a) the institution's representative has discussed the benefits of Credit Protection with us. b) if we are unable to meet the financial contract obligations due to accident, sickness, injury, disability or involuntary unemployment, we are still liable for meeting the financial obligations of this contract. c) in the event of death, we acknowledge that it will be the estate's responsibility to repay the loan. General Insurance We offer a range of general insurance products. Would you like more information on this service? Home and Contents Car Boat Caravan PART 13 - Financial Planning Dnister utilises the services of Bridges Financial Services Pty Ltd to provide members with Financial Advice. A consultation may be arranged with a local Bridges planner. Would you like Dnister to arrange an appointment? PART 14 - Products and Services Dnister provides a wide range of banking products and services for its members. Please indicate if you are interested in obtaining additional information in relation to some of these attractive services. PART 15 - Additional Information High Interest Online Savings Accounts Internet and Phone Banking Fixed Term Deposit Products ATM and EFTPOS Account Community Saver Have any applicant ever been declared Bankrupt or had a Court Order made against you for non payment of a debt? Are there any unsatisfied judgements / legal action against any applicant? Have any applicant(s) entered into a Scheme of Arrangement for debt repayment? Have any applicant(s) had property repossessed? Are any applicant(s) or guarantor(s) a guarantor for another person's loan / debt? If you answered YES to any of the above please provide details below: Page 8 of 13

PART 16 - Business Purpose Declaration Is the purpose of the loan wholly or predominantly for personal, domestic or household use or for investment in residential property? (Regulated Loan - Skip Declaration) IMPORTANT : I/we declare that the credit to be provided to me/us by Dnister is to be applied wholly or predominately for business purposes or investment purposes other that investment in residential property. I/we understand that by signing this declaration I/we may lose my/our protection under the National Credit Act. PART 17 - Privacy and Disclosure What information can be disclosed? The Privacy Act allows Dnister Ukrainian Credit Co-operative Limited ('we', 'us', 'our') ACN 59 087 651 394 and other applicable persons to disclose personal information about you when related to the primary purpose for which it was collected. In connection with providing credit to you, personal information may include credit information, such as: details to identify you and verify your identity, such as your name, sex, date of birth, current and 2 previous addresses, your current and last known employer, and your driver's licence number the fact that you have applied for credit and the amount or that we are a current credit provider to you, or that you have agreed to be a guarantor advice that payments previously notified as unpaid are no longer overdue information about your current or terminated consumer credit accounts and your repayment history payments overdue for at least 60 days and for which collection action has started in specified circumstances, that in our opinion you have committed a serious credit infringement the fact that credit provided to you by us has been paid or otherwise discharged, and other information about credit standing, worthiness, history or capacity that credit providers can disclose under the Privacy Act, including a credit report. Your sensitive information (eg, membership of a professional or trade association) may also be disclosed where relevant to this application. Why do we obtain information? Before, during or after the provision of our products and services to you, we may obtain your personal information for the purpose of providing products and services to you and managing our business. When providing credit to you, this may include assessing your application for consumer or commercial credit or to be a guarantor for the applicant, assessing your credit worthiness, managing your loan or the arrangements under which your loan is funded or collecting overdue payments. If you do not provide us with the personal information that we request, we may not be able to consider your application for credit or provide other services. Who can give or obtain information? For the purpose of providing products and services to you and managing our business, we may give information to: external service providers to us, such as organisations which we use to verify your identity, payment systems operators, mailing houses and research consultants insurers and re-insurers, where insurance is provided in connection with our services to you superannuation funds, where superannuation services are provided to you debt collecting agencies, if you have not repaid a loan as required our professional advisors, such as accountants, lawyers and auditors state or territory authorities that give assistance to facilitate the provision of home loans to individuals other credit providers and their professional advisors your representative, for example, lawyer, mortgage broker, financial advisor or attorney, as authorised by you, or government and regulatory authorities, if required or authorised by law. In addition, in connection with providing credit to you, we and the Credit Providers mentioned below may: obtain a commercial and consumer credit report containing personal information about you from a credit reporting body obtain personal information about you from your employer and any referees that you may provide. exchange credit information about you with each other, and exchange credit information about you with any credit reporting body and any other provider of credit to you named in your credit application or a credit report from a credit reporting body. Page 9 of 13

Credit Providers can mean: us any introducer, dealer or broker referred to in a loan application any agent or contractor of ours assisting in processing a loan application, and other entities that may be involved in a securitisation arrangement which we use to fund your loan, including without limitation Trinity and any loan originator. Overseas disclosures We will not disclose your personal information overseas. However, if we do disclose this information outside Australia, we will do so on the basis that the information will be used only for the purposes set out in this document. Important information about credit reporting bodies If you apply for or hold any kind of credit with us, we may disclose information to a credit reporting body. That includes disclosing that you are in default under a credit agreement or have committed a serious credit infringement, if that is the case. (Specifically, we may disclose information to or collect information from [Veda Advantage, whose privacy policy and contact details are at www.veda.com.au Credit reporting bodies collect credit information about individuals which they provide as credit reports to credit providers and others in the credit industry to assist them in managing credit risk, collecting debts and other activities. "Credit pre-screening" is a service for credit providers wishing to send direct marketing material about credit services. A credit reporting body uses information it holds to screen out individuals who do not meet criteria set by the credit provider. Credit reporting bodies must maintain a confidential list of individuals who have opted out of their information being used in pre-screening. To opt out of credit pre-screening, contact the credit reporting body, using the contact details on their websites, referred to above. You can also ask a credit reporting body not to use or disclose your personal information for a period if you believe on reasonable grounds that you have been or are likely to be a victim of fraud, including identity fraud. "Credit pre-screening" is a service for credit providers wishing to send direct marketing material about credit services. A credit reporting body uses information it holds to screen out individuals who do not meet criteria set by the credit provider. Credit reporting bodies must maintain a confidential list of individuals who have opted out of their information being used in pre-screening. To opt out of credit pre-screening, contact the credit reporting body, using the contact details on their websites, referred to above. You can also ask a credit reporting body not to use or disclose your personal information for a period if you believe on reasonable grounds that you have been or are likely to be a victim of fraud, including identity fraud. Disclosure to insurers and guarantors Lenders' mortgage and trade insurers In connection with providing credit to you, a lenders' mortgage insurer or a registered trade insurer may obtain credit information about you from a Credit Provider or from a credit reporting body to assess whether to provide lenders' mortgage insurance to us in relation to an application for consumer credit, or whether to provide trade insurance to us in relation to an application for commercial credit. Guarantors In connection with providing credit to you, the Credit Providers may give a guarantor, or a person who is considering becoming a guarantor, credit information about you for the purpose of enabling the guarantor to decide whether to act as guarantor or to keep informed about the guarantee. Personal information about third parties You represent that, if at any time you supply us with personal information about another person (for example a referee), you are authorised to do so; and you agree to inform that person who we are, how to contact us, how to obtain our Privacy Policy, and that we will use and disclose their personal information for the purposes set out in this Permission and that they can gain access to that information. Electronic verification Under the AML/CTF Act, we can disclose your name, residential address and date of birth to a credit reporting body. The purpose of this disclosure is to ask the credit reporting body to assess whether the personal information disclosed matches (in whole or part) personal information about you held in their records (if any). This electronic verification process helps us to verify your identity. The credit reporting body may prepare and provide us with an assessment by using the personal information about you and the names, residential address and dates of birth contained in its records about other individuals. If you not consent to us verifying your identity by electronic verification, we will provide you with an alternate verification process to identify you. If this is the case, please contact us on 1300 363 041 for further information. Page 10 of 13

Security, privacy policy, and marketing preferences Security We take all reasonable steps to ensure that all your personal information held by us (on our website or otherwise), is protected from misuse, interference and loss, and from unauthorised access, disclosure or modification. Privacy & Credit Reporting Policy Our Privacy & Credit Reporting Policy /privacy provides additional information about how we handle your personal information. It sets out how you can ask for access to personal information we hold about you and seek correction of that information. It also explains how you can complain about a breach of the Privacy Act or the Credit Reporting Privacy Code, and how we will deal with your complaint. We will give you a copy of our Privacy & Credit Reporting Policy on request. Marketing preferences The Credit Providers may use, and share with each other, information about you to inform you about products and services (unless you ask us not to). The Credit Providers may do so even if you are on the Do t Call Register. PART 18 - Declaration 1. I/we make application for a loan / overdraft in the amount / for the limit set out in this application form. I/we acknowledge that no obligation is imposed upon the credit co-operative to approve my/our application. 2. I/we agree to pay all legal and valuation expenses in connection with processing this loan application irrespective of whether or not the loan is approved. 3. The information set out in this application is true and correct in every particular and I/we have no financial commitments, debts, liabilities, or financial obligations other than those disclosed within this application. 4. I/we also understand and confirm that I/we have read, understood, agree to and give the acknowledgments, authorities and consents contained within this application. 5. If a redraw facility applies to the product selected, I/we acknowledge that: a) I/we will be jointly and severely liable for all redraw transactions; b) for internet banking redraws, if there is more than one borrower under the loan contract, you authorise us to process the drawback on the instruction of any of you; and c) for counter redraws, if there is more than one borrower under the loan contract, all borrowers will be required to authorise redraws. Applicant or Guarantor (1) Applicant or Guarantor (2) Full Name Full Name Signature Date Signature Date Please forward this completed and signed application to Dnister by mail or via the fax number listed. If you have any queries or require further assistance please contact our loans department Page 11 of 13

BRANCH USE ONLY ( to be completed by Dnister personnel) Based on the information contained in this application and my enquires, I believe the loan meets the applicant's requirements and objectives and they will be able to meet their financial obligations without substantial hardship. I therefore recommend that the loan be assessed as 'not unsuitable'. Specific Loan Suitability Assessment Comments. (Loan product selected must satisfy the client's requirements and/or objectives. If re-financing, must include financial details and comments about existing loan): Please include comments here : COUNTERPARTY EXPOSURE This loan amount Dnister loan amounts Total Dnister counterparty exposure 0.00 SECURITY POSITION This loan amount loans secured by this security A Total loans secured by this security 0.00 Value of this security Value of other security B Total security value 0.00 = LVR (loan to valuation ratio) A/B % NDI RATIO NDI Ratio: :1 LOANS DELEGATIONS POLICY Exceptions and Mitigants DISCRETIONARY LENDING AUTHORITY (DLA) Board CEO Lending Manager Branch Manager Lending Officer APPLICATION RECOMMENDED BY Staff Full Name APPROVAL / FINAL LOAN SUITABILITY ASSESSMENT Staff Full Name Signature Date Signature Date Please forward this completed and signed application to Dnister by mail or via the fax number listed. If you have any queries or require further assistance please contact our loans department Page 12 of 13

PERSONAL NOTES YOUR LOANS REPRESENTATIVE Once completed, please return this form with relevant documentation to your Loans representative or by submitting your application as per below. Dnister Ukrainian Credit Co-operative Head Office : 912 Mt Alexander Road (PO Box 279) Essendon VIC 3040 (03) 9375 1222 Adelaide Branch : 62 Orsmond Street (PO Box 260) Hindmarsh SA 5007 (08) 8346 6174 Geelong Branch : 3/29-35 Milton Street Bell Park VIC 3215 (03) 5278 5950 Perth Agency : PO Box 154 Maylands WA 6051 loans@dnister.com.au Page 13 of 13