Application Checklist Page 2
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Application
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Applicant
A.B.N.:
A.C.N:
Address
Industry/Occupation
Contact Name
Phone
Years est.
Date of Incorporation / /
Fax
Accountant
Bank
Address
Branch
BSB
Contact
Phone
Account no.
INDIVIDUALS/ GUARANTORS/ DIRECTORS
Name
1)
2)
Address
Yrs at address:
Yrs at address:
Phone
Date of Birth / /
Date of Birth / /
Driving lic. No.
Driving lic. No.
Home Owner □
Renter □
Home Owner □
Renter □
FINANCE ‐ DETAILS
Payment Frequency (Please tick one): □ Monthly □ Quarterly
Equipment/ Assets:
Rent instalment: $
Supplier:
GST per Rent Instalment:
$
Cost price $
Total Rent Instalment:
$
Term (months) – Please tick:
□ 36
TRADE/CREDIT REFERENCES
Company name
1)
Contact name:
2)
Contact name:
Phone
Fax
Phone
Fax
STATEMENT OF FINANCIAL POSITION
Assets & Liabilities of:
Assets & Liabilities of:
Assets
Liabilities
Assets
Liabilities
Bank/Cash
Mortgages
Bank/Cash
Mortgages
Land/Buildings
Other loans
Land/Buildings
Other loans
Motor vehicles
Finance co.
Motor vehicles
Finance co.
Investments
Bank overdraft
Investments
Ban overdraft
Other
Other
Other
Other
Total
Total
Total
Total
Surplus
Surplus
I/We declare that the information given is true and correct.
I/We authorise Macquarie Equipment Rentals Pty Limited to make any enquiries it considers necessary to verify the above information.
Applicant signature:
Date :
Applicant signature:
Date :
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Parent category: Business