Application - Ecolease

Online Application

Ecolease Finance Application

Ecolease Pty. Ltd. A.B.N.: 43 135 937 852. Australian Credit License No.: 395119. Member of CAFBA.

Step 1 of 7 - Business Details

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Trading Name*
ABN*
ACN
GST Registered?*
- Yes
- No
Entity Type*
- Soletrader
- Partnership
- Corporation
- Trust
Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Time at Address: years and months*
Commercial Property Status*
- Renting
- Mortgaged
- Own
Monthly Rental Payments*
Monthly Mortgage Repayments*
Your Industry*
Annual Turnover*
Number of Full time Staff*
Phone*
Email*

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Individual/Director/Partner Authorised Signatory No. 1
Name in Full*
First Middle Last
Date of Birth*

Day
Month
Year
Do You Hold a Drivers Licence?*
- Yes
- No
Drivers Licence Number*
Drivers Licence Card/Document Number*
Drivers Licence Expiry Date*

Day
Month
Year
Please provide either Passport or Photo ID Card Number*
Expiry Date*

Day
Month
Year
Residential Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Have You Resided at this Address for 2 Years or More?*
- Yes
- No
Time at Present Address: years and months*
Your Previous Address if Less than Two Years at Above Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Best Contact Details:*
- Landline Phone
- Mobile
- Either
Landline Phone*
Mobile Phone*
Mobile Phone
Email*
Residential Status*
- Owner
- Renter
- Owner + Renter
Ownership Status*
- Own House Outright
- Mortgage
Property Value*
Mortgage Value*
Monthly Mortgage Repayments*
Monthly Rental Payments*
Are There Additional Directors/Signatories to this Loan Application?*
- No
- Yes

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Individual/Director/Partner Authorised Signatory No. 2
Name in Full*
First Middle Last
Date of Birth*

Day
Month
Year
Do You Hold a Drivers Licence?*
- Yes
- No
Drivers Licence Number*
Drivers Licence Card/Document Number*
Drivers Licence Expiry Date*

Day
Month
Year
Please provide either Passport or Photo ID Card Number*
Expiry Date*

Day
Month
Year
Residential Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Have You Resided at this Address for 2 Years or More?*
- Yes
- No
Time at Present Address: years and months*
Your Previous Address if Less than Two Years at Above Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Best Contact Details:*
- Landline Phone
- Mobile
- Either
Landline Phone*
Mobile Phone*
Mobile Phone
Email*
Residential Status*
- Owner
- Renter
- Owner + Renter
Ownership Status*
- Own House Outright
- Mortgage
Property Value*
Mortgage Value*
Monthly Mortgage Repayments*
Monthly Rental Payments*
Are There Additional Directors/Signatories to this Loan Application?*
- No
- Yes

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Individual/Director/Partner Authorised Signatory No. 3
Name in Full*
First Middle Last
Date of Birth*

Day
Month
Year
Do You Hold a Drivers Licence?*
- Yes
- No
Drivers Licence Number*
Drivers Licence Card/Document Number*
Drivers Licence Expiry Date*

Day
Month
Year
Please provide either Passport or Photo ID Card Number*
Expiry Date*

Day
Month
Year
Residential Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Have You Resided at this Address for 2 Years or More?*
- Yes
- No
Time at Present Address: years and months*
Your Previous Address if Less than Two Years at Above Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Best Contact Details:*
- Landline Phone
- Mobile
- Either
Landline Phone*
Mobile Phone*
Mobile Phone
Email*
Residential Status*
- Owner
- Renter
- Owner + Renter
Ownership Status*
- Own House Outright
- Mortgage
Property Value*
Mortgage Value*
Monthly Mortgage Repayments*
Monthly Rental Payments*
Are There Additional Directors/Signatories to this Loan Application?*
- No
- Yes

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Individual/Director/Partner Authorised Signatory No. 4
Name in Full*
First Middle Last
Date of Birth*

Day
Month
Year
Do You Hold a Drivers Licence?*
- Yes
- No
Drivers Licence Number*
Drivers Licence Card/Document Number*
Drivers Licence Expiry Date*

Day
Month
Year
Please provide either Passport or Photo ID Card Number*
Expiry Date*

Day
Month
Year
Residential Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Have You Resided at this Address for 2 Years or More?*
- Yes
- No
Time at Present Address: years and months*
Your Previous Address if Less than Two Years at Above Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Best Contact Details:*
- Landline Phone
- Mobile
- Either
Landline Phone*
Mobile Phone*
Mobile Phone
Email*
Residential Status*
- Owner
- Renter
- Owner + Renter
Ownership Status*
- Own House Outright
- Mortgage
Property Value*
Mortgage Value*
Monthly Mortgage Repayments*
Monthly Rental Payments*

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Banking Details
Business Bank Name*
Account Name*
BSB Number*
Account Number*
Do You Have an Accountant?*
- Yes
- No
Your Accountants Name
First Last
Your Accountants Email
Your Accountants Preferred Contactable Phone Number
Do You Have any Existing Loans?*
- Yes
- No
Contract Number*
Remaining Length of Term*
Monthly Repayments Value*
What type of Equipment/Asset?*

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Details relating to the equipment your loan application is for.
Supplier
Name of Saleperson
First Last
Salesperson's Preferred Contactable Phone Number
Their Email Address
Description of the Equipment You Are Wanting to Finance*
Equipment Price ($)*
Your Preferred Term of Loan (Months)
Quoted Monthly Repayment
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Email
This field is for validation purposes and should be left unchanged.

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