Roland Rental Loan Application - Ecolease

finance application

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*
Drivers Licence 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*
Drivers Licence 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

Save and Continue Later

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*
Drivers Licence 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

Save and Continue Later

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*
Drivers Licence 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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Comments
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"*" indicates required fields

First Name*

Last Name*

Email*

Phone

Equipment Type*

Equipment Value/ Sale Price ($)

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