Please complete all sections of the Application Form.
Introducers Details

Company

Contact

Email

Mobile

 
Finance Type  

Other (Please Specify)

 

Applicant Details

Company

ABN

Nature of Business

Years in Business:

Contact

Email

Telephone

Mobile

Fax

Address

Suburb

State

Postcode

Use for Funds

Type of equipment


Other

Equipment Supplier

Equipment Value (incl GST)

Less Deposit

Residual%

Term

 
 
References
Trade    
Name Contact Phone
Credit/Finance Reference    
Name Contract No: Phone
Credit History - clean Yes No
If no , please provide details in the space below and attach any relevant documentation
Other (Please Specify)
 

Personal Details

Position:

Property owner: Yes No

Value

Mortgage

Name

Position

Date of Birth

Drivers License No:

Email

Personal Details

Position:

Property owner: Yes No

Value

Mortgage

Name

Position

Date of Birth

Drivers License No:

Email

 

Contacts

Accountant Bank
  Please provide debt slip or recent bank statement
Firm Name
Contact BSB
Phone A/C Number
Email Phone
   
 
Notes Attachments
Once the file is finished uploading, it will appear in the Uploaded Files section. You may upload another file after this.

Uploaded Files:

 
Privacy Declaration and Authorisation to Release Information

I/we (being the Lessee/s) hereby certify that the information that has been provided is wholly true and not misleading. Pursuant to the Privacy Act 1988 (Cth), I/we authorise and consent Assetfin Australia Pty Ltd ACN 133 732 706 ABN 75 133 732 706 (‘Assetfin’), Global Capital Corporation ABN: 14 097 482 114 and interested parties collecting from and providing to credit reporting agencies personal information (being consumer credit information and any other relevant information about me/us), and to seek and obtain consumer credit references/reports to allow Assetfin to assess my/our application, manage my/our account, recover any money that I/we owe, and/or finance another product (currently or in the future) to me/us. I/we also acknowledge that the credit/commercial credit applied for may be provided by another credit provider. I/we acknowledge and authorise that in such cases, Assetfin may disclose my/our personal information to such credit provider for the purposes of assessing my/our application, including information about my/our consumer or commercial credit worthiness or financial capacity. I/we acknowledge and authorise you to disclose my/our personal information to others who perform a function or service for, or related to the purposes you collect, use or disclose the information, including agents. These may include introducers, debt collection agents, valuers, solicitors or accountants, and funders. You may also seek information from government authorities or others to enable you to identify me/us and verify information I/we have provided. This may be to locate me or us or the assets. It may include searches of electoral rolls, land titles, business names or ASIC, bankruptcies and court judgments and telephone numbers. I/we acknowledge that if we fail to provide sufficient personal information, my/our application may not be able to proceed. I/we acknowledge that I/we may access my/our personal information by contacting Assetfin on 02 8080 7330. I/we further authorise our accountant or financial officer to provide Assetfin such information, if any, which Assetfin may require in relation to our financial position including copies of our financial statements for the purposes of assessing this application. I/we also authorise you to collect personal information about me/us from my/our introducer, legal advisers, and referees.
Acknowledgement and Consent of Guarantor(s): By ticking the box below I/we acknowledge and consent to the following: I/we have read the Authorisation set out above and understand that it applies equally to me/us as guarantor(s). I/we acknowledge that Assetfin, Global Capital Corporation and interested parties may see a credit report concerning me/us from a credit reporting agency and all other information as set out above for the purpose of assessing whether to accept me/us as a guarantor for the finance commitments of the above named Lessee(s). I/we agree that this agreement remains in force until the attached agreement, which I/we hereby guarantee, ceases.

 
This form does not constitute a contract.
Assetfin will contact you to discuss this facility and finalise the documentation.
   
I hereby consent to the above privacy declaration
     
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