AIFA Shariah Advisory Application Form

Shariah Advisory Application Form

ANIC Islamic Finance Advisory (AIFA)
1. Entity Details
a. Legal Name:*
b. Trading Name:
(If applicable)
c. ABN:
d. Legal Structure of Entity:
(Company/Partnership/Trust ect.)
e. Business Address:*

Street Address

Street Address Line 2

CityState

Postcode
Postal Address As Above
f. Postal Address:

Address - POBOX

Street Address Line 2

CityState

Postcode
g. Entity's Website:
www.example.com
2. Details of Financial Product Endorsement Sought
a. Product/s Name:
b. Product Type:

1) Home Loan2) Managed Investment Scheme3) Superannuation4) Car LoansOther Products
c. Legal Agreements/Contracts/Documents Including:

1) Financing Agreement2) Product Description3) Product Application Form4) Lease Agreement5) Product General Terms & Conditions6) Product Disclosure Statement (PDS)7) Agency Sale & Purchase Agreement8) Product Issuer’s View on Shariah ComplianceOther Documents
3. Details of Current License and Delegation
a. Types of License:

1) Australian Financial Services License (AFSL)2) National Credit Code3) Conditions on LicenseeOther License
AFSL and/or Corporate Authorised Representative Number
b. Delegation Details:

(If applicable)
Licensee:
Legal Delegate/Representative:
Delegation Terms & Conditions:
4. Contact Details
a. Authorised Contact Name:
b. Designation/Position:
c. Phone:
0123456789
d. Email:
example@example.com
5. Authorisation
Signature:

Clear
Full Name:
Date

DayMonthYear
Date
File Upload

Cancelof
Privacy Note: AIFA respects your privacy and keeps your information confidential by complying with the Privacy Act 1988. AIFA only uses your information for the purposes it is collected and, in this case, for the purposes of the Shariah accreditation and certification of your financial product or products. AIFA does not disclose any information to any third party unless required by an Australian law.
Should be Empty:

Shariah Advisory Application Form

1. Entity Details

2. Details of Financial Product Endorsement Sought

3. Details of Current License and Delegation

b. Delegation Details:

4. Contact Details

5. Authorisation