Enquiry Form
Equipment Finance
( compulsory fields * )
Introducer Details
Introducer Type:*
ASIC Licence:
Licence No:
GCC Accredited:
Company:
Contact:
Aggregator:
GCC Introducer No:
Tel:
Mobile:
Email:
Borrower Details
Company:
Contact:*
Nature of Business:
Address:
ABN:*
Years in Business:
Tel:
Mobile:*
Email:*
Personal Details of Borrowers / Directors / Partners
Full Name 1:*
Full Name 2:
Address:
Address:
DOB:
Drivers Licence No:
DOB:
Drivers Licence No:
Tel Home:
Mobile:
Tel Home:
Mobile:
Email:
Do you own property?*
Email:
Do you own property?
Property Value:*
$
Mortgages:
$
Property Value:
$
Mortgages:
$
Security Details
Detailed Description
Make/Model
Year
Supplier
Value
1)*
$*
2)
$
3)
$
4)
$
5)
$
Loan Details
Borrower Type:*
Loan Purpose:*
If Refinance or Replacement payout:
$
Loan Type:*
Other (specify)
Total Security Value:*
$
Deposit:
$
Use of Equipment:*
Finance Amount:*
$
Residual:
%
Loan Term:*
Total Gross Income:
$
Total Net Income:
$
Current Financials Available?*
Borrowers Credit History:*
If Not Clear Explain:
Transaction History:*
Has the deal been shopped?
If Yes Explain:
Contact Reference Details
 
Name
Contact
Phone
Email
Trade
Finance
Accountant
Comments: (Scenario & Borrower Backgorund Information)
How did you hear about us?*:
please specify:
Please ensure that all the above information is accurate as it will directly affect the accuracy of the indicative funding proposal
Please provide any supporting information that may be relevant in assessing the funding proposal

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