Gem Visa card

Acknowledgement and Authorisation

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To: Latitude Financial Services Limited, PO Box 4058, Shortland Street, Auckland 1140 ("Latitude").

I apply for a Gem Visa account and credit card. If I am offered and accept a Gem Visa account and credit card, I understand I will be provided with a disclosure statement and Conditions of Use, governing my Gem Visa facility, and agree to be bound by these documents.

I understand there is no obligation to provide personal information, including driver licence details, but, if I fail to supply any information requested, or do not agree to any of the disclosures detailed in this acknowledgement, my application may not be accepted. I certify that all information supplied in my application is true and complete, and where applicable, I have the permission of my spouse/partner to disclose his/her personal information.

I authorise Latitude to make all necessary enquiries and receive information concerning my credit rating, any outstanding fines, residence, employment and my identity from other credit providers, credit reporters, government agencies, my employer, accountant, or other named persons or relatives and, where applicable, to obtain such information relating to my driver licence from Land Transport NZ as is authorised by the Land Transport Act 1998 for the purposes of considering my application, the administration and protection of any credit provided and considering any future request from me to increase the credit limit on my account. I agree that this authority may be provided to such parties for these purposes. I also agree that my personal information may be shared with NZ Post, any Gem Visa merchant, or any other entity employed by Latitude for the purpose of verifying my identity.

I agree that any credit reporters' monitoring services may be used to receive updates if the information held about me changes. I understand that Latitude will give my information (including without limitation, repayment history information, details relating to my account, and payment default details) to credit reporters for these purposes and that those credit reporters may hold the information on their systems and disclose it to authorised users of the credit reporters' services. I also understand that information about my creditworthiness and credit history may be disclosed to any credit provider named in a credit report relating to me.

Where my application is initiated via a merchant website, I agree that my information may be shared with that merchant for the purpose of marketing its products and services.

I authorise Latitude and its related entities share and use all personal information held about me now or in the future to offer me further finance, to consider any future application of finance from me, and to offer or provide me with details of other products and services from time to time. I agree that such details may be sent by mail, email or telephone (including SMS/MMS). The personal information will be held at the offices of Latitude. Where it may readily be retrieved, I shall have access to it and the right to request correction.

If I am offered and accept a Gem Visa account and credit card, I consent to all disclosure documents required for the purpose of the Credit Contracts and Consumer Finance Act 2003 being sent either by mail or in electronic form and by means of electronic communication (either by email or accessible from a website or by means of the Internet). I understand that if I withdraw this consent at any time I may be required to pay a fee to cover the cost of providing paper statements.