Application Form For Equipment FinanceHome>Application Form For Equipment Finance> Office Use Only Declaration: Have You Met With Your Client For This Application Yes No Facility: Chattel Mortgage Consumer Lease Novated Rental Company/Sole Trader Name Registered date A.C.N. A.B.N. Trust Name (if applicable) Trust A.B.N. Registered for GST: Yes No Since Business Address: Time at above address: Years Months If less than 3 years, please provide previous address. Previous address (if applicable) Since Office Ph Fax Mobile Nature of Business Est for Years Brief description of business operations/background Company Director/s 1. 2. 3. 4. Names of Beneficiaries 1. 2. 3. 4. Trade References: Does the business have credit terms with a supplier? If yes, please complete: Name of Trade Supplier Contact Ph Who is your accountant? Accountancy Firm Name Contact Name Contact Ph Individual or Director 1: Full Name: Mr/Mrs/Miss/Ms Date of Birth Mobile Email Citizenship Status: Australian Other Residential Status: Owner Boarder Renter(If Renter, pls provide Landlord details) Weekly paid: $ Real Estate Agent/Landlord Name Phone Number Home address Time at above address If less than 3 years, please provide previous address. Previous address (if applicable): Since Current Employer Full Time Part Time Casual Position Since Income: $ Gross/Net per wk fn yr Previous Employer & position if <3 years: Since Married Single De Facto Dependants? Yes No Ages Driver Licence* No: Expiry Date Medicare* No Expiry Date *Certified & clear copies of your ID will be required at settlement for new clients. If one of these documents is unavailable, please provide a secondary form of ID to satisfy Anti-Money Laundering legislation.Individual or Director 2: Full Name: Mr/Mrs/Miss/Ms Date of Birth Mobile Email Citizenship Status: Australian Other Residential Status: Owner Boarder Renter(If Renter, pls provide Landlord details) Weekly paid: $ Real Estate Agent/Landlord Name Phone Number Home address Time at above address If less than 3 years, please provide previous address. Previous address (if applicable): Since Current Employer Full Time Part Time Casual Position Since Income: $ Gross/Net per wk fn yr Previous Employer & position if <3 years: Since Married Single De Facto Dependants? Yes No Ages Driver Licence* No: Expiry Date Medicare* No Expiry Date *Certified & clear copies of your ID will be required at settlement for new clients. If one of these documents is unavailable, please provide a secondary form of ID to satisfy Anti-Money Laundering legislation. Individual 1 Name Asset Position 1TypeAddress / DescriptionValue $Home Residence(Please provide rates notice)$Investment Property 1$Investment Property 2$Motor Vehicle 1$Motor Vehicle 2$Cash at Bank$Home Contents Value$Superannuation$Other$Liabilities Position 1TypeBankRepayment $Limit $Balance $Home LoanPersonal LoanInvestment Loan 1Investment Loan 2Credit Card 1Credit Card 2Equipment Loan 1Equipment Loan 2Other Are you aware of any credit defaults or judgements on your credit file? Yes NoIf yes, please provide details: Name of organisation: Amount: $ Signature Date Signature Date Individual 2 Name Asset Position 2TypeAddress / DescriptionValue $Home Residence(Please provide rates notice)$Investment Property 1$Investment Property 2$Motor Vehicle 1$Motor Vehicle 2$Cash at Bank$Home Contents Value$Superannuation$Other$Liabilities Position 2TypeBankRepayment $Limit $Balance $Home LoanPersonal LoanInvestment Loan 1Investment Loan 2Credit Card 1Credit Card 2Equipment Loan 1Equipment Loan 2OtherIf you need more space, please attach a separate page with the additional information. Are you aware of any credit defaults or judgements on your credit file? Yes NoIf yes, please provide details: Name of organisation: Amount: $ Signature Date Signature Date Asset to be financed Goods Description: New Used Year of Manufacture Purpose of goods? Are these goods Additional or Replacement? General Description If current goods are under finance, please provide details in Finance References section below. Supplier Contact Name Contact Ph Supplier Email Cost Price: $ Deposit/Trade in: $ Amount Financed: $ Term Residual/Balloon: $ If you have a Contract of Sale or Purchase Order, please attach a copy.Finance References: Please list any current and/or paid in full equipment loans: Bank/Finance Company Contract No Paid? Y N Goods Monthly repayment: $ Servicing: Some loans will need to be assessed for servicing. Please provide the below to ensure you meet servicing criteria.Description of living expenseMonthly AmountMortgage/Rent/Board (i)$Rates & Utilities (i)$Groceries (i)$Clothing & Personal Care (i)$Education (Childcare, preschool, secondary, tertiary) (i)$Telephone & Internet (i)$Pay TV (i)$Insurance (i)$Medical & Health (i)$Transport – Public (i)$Motor Vehicle Running Costs (i)$Recreation & Entertainment (i)$Others$Please Download PRIVACY ACT for signing and upload.Please upload the duly filled & signed form below. Choose file SUBMIT
