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Lender Application Form

Lender Application Form
LENDERS NAME:
INVESTMENT LEVEL:
PREFERRED INVESTMENT TYPE:
PREFERRED INVESTMENT TERM:
PREFERRED TYPE OF SECURITY:
LENDER APPLICANT DETAILS 1:
LENDER APPLICANT DETAILS 2:
CONTACT DETAILS 1:
PAYMENT - Electronic Banking
DECLARATION AND SIGNATURE:
Please read Broker Agreement before signing this form.

This Application accompanies the Lightspeed Finance Broker Agreement which contains information which should be read before applying to become a Lender.

I/We agree to be bound by the provisions of the Broker Agreement.

I/We acknowledge that investments are not deposits with or other liabilities and are subject to investment risk, including possible delays in repayments and loss of principle invested.

I/We further acknowledge that the Lightspeed Finance Broker Agreement does not guarantee the performance of the Loan nor does it guarantee the repayment of capital from the Loan

 

   

 

   
POWER OF ATTORNEY:

In signing under a Power of Attorney, you are verifying that at the time of signing you have not received notice of revocation of that Power. Please provide a certified copy of the Power Of Attorney including appointed signature.