Finance Application - Private Company / Partnership / Sole Trader
Client Details
 Private Company Partnership Sole Trader
Applicant/Company Name
 ABN/ACN
Trading As
Business Trading Address
 State Postcode
Business Postal Address
 State Postcode
Primary Contact - Name
Primary Contact - Telephone
 ‹-- Must Be a Landline, Including Area Code
Mobile Phone Number
 Fax Number (Inc. Area Code)
Email
 Website URL
Business Type
 Current Owners Since Years In Business
Current Business Committments
1) Financier
 Expiry Date Monthly Repayments $
2) Financier
 Expiry Date Monthly Repayments $
3) Financier
 Expiry Date Monthly Repayments $
4) Financier
 Expiry Date Monthly Repayments $
Referee Details
Accountant
 Accountant's Phone
Bank
 Branch
Trade Reference 1 (min 1 year)
 Contact Name Ph Years Established
Trade Reference 2 (min 1 year)
 Contact Name Ph Years Established
Supplier Details
Supplier
 Contact Name Ph
Equipment Description
Required Term (months)
 Balloon % Residual / $ Cost Price (Ex GST)
Replacement Committment
 Yes No
If Motor Vehicle, is it a private sale ?
 Yes No
Details of Director/Partner/Guarantor
1) Full Name
 D/License# Expiry DOB
Current Address
 Years At Location
Premises
 Owned Leased
Monthly Rent
2) Full Name
 D/License# Expiry DOB
Current Address
 Years At Location
Premises
 Owned Leased
Monthly Rent
Personal Statement of Assets and Liabilities
ASSETS
LIABILITIES
Property Address Mortgage
(1) $ (1) $
(2) $ (2) $
Motor Vehicles Personal Loans (incl. c/cards)
(1) $ (1) $
(2) $ (2) $
Furniture & Fittings $ Other $
Cash In Bank $  
Investments/Other $  
TOTAL $ TOTAL $
 
 

Please note: Due to statutory requirements, we will also require you to download and sign a
Privacy Act Consent Form, and fax back to us at your earliest opportunity on 1300 138 089.