Online Application

Please complete the below Application form for your equipment finance. Please ensure you complete the following mandatory fields:

Reference#:

CLIENT DETAILS
Company Partnership Individual Other
Legal Name A.C.N
Trading As A.B.N
Business Address P/Code
Business Suburb
Postal Address P/Code
Postal Suburb
Contact Telephone
Nature of Business Facsimile
Email Website
Years Est. No. of Employees
Payment Method Monthly Direct Debit   Quarterly Direct Debit

REFEREE DETAILS

Authority to contact Accountant for financial information, if required Yes No
Accountant Contact Tel
Bank Branch State
Trade Ref 1 Contact Tel
Trade Ref 2 Contact Tel

SUPPLIER DETAILS
Supplier Contact Tel
Equipment Description Payment
(inc ex GST) 		Term
(months)
Finance Type   Rental     Lease     CHP   Goods     New or   Used
Residual   $

AGREEMENTS & PRIVACY DECLARATION


In compliance with the Commonwealth Privacy Act 1988, the Applicants and Guarantors (“I/We”) to the finance application must complete and provide this agreement. Name of Credit Provider; Alliance Equipment Finance Pty Limited A.B.N 79 074 206 634 (“Alliance”).
• I/We agree to you obtaining a report about my/our consumer or commercial credit worthiness from a credit reporting business respectively for the purpose of assessing this credit application, administering the account and collecting any overdue payments; in so doing,
• I/We acknowledge that information from this application or concerning the lender’s current credit provider status may be disclosed; and
• I/We also agree that you may give to and receive from another credit provider a report about my/our consumer or commercial credit worthiness for the purpose of assessing a credit application made by me/us to another credit provider or collecting any payment that is overdue to a credit provider.
• I/we acknowledge that where the credit applied for is provided by a credit provider other than you, you may disclose my/our personal information to such credit provider and such personal information may be used for the purposes of assessing my/our application for credit or to be a guarantor, and if the application is approved, for the purposes of administering and doing all matters in connection with the credit provided or the guarantee.
• I/We acknowledge that a reference to Alliance in this declaration is also a reference to such credit provider, and that such credit provider may disclose my/our personal information to any person or use my/our personal information for any purpose, that Alliance is permitted to under this Declaration.
• I/we acknowledge that such credit provider may also disclose my/our personal information to its related entities for prudential and administrative purposes, and to persons overseas if they are employees or contractors to related entities.
 • I/we acknowledge that I/we may access my/our personal information or request information regarding such credit provider by contacting 1300 362 800.
• I/we acknowledge and agree that you may disclose the information provided by us in this application and any further information that I/we may subsequently provide:-
• to any entity involved in any restructure or transfer of Alliance or
• any related bodies corporate of Alliance; or
• any employees, agents, contractors or other service providers of Alliance; and
• any external advisers that Alliance believes may be able to provide us with professional advice; for any of the following purposes or may itself use that information for those purposes:
• as part of carrying on the activities of your business including any restructure or transfer
• to provide further information that is targeted to our expected interests or needs or otherwise to enhance the services provided by you to us; or
• to conduct market research and better understand the characteristics of its customer base, including to contact us in the future for feedback; or
• to market additional services to assist you in your business.
If you do not want your information to be used for such purposes contact us on 1300 362 800.

DETAILS OF DIRECTOR(S) / PARTNER(S) / PROPRIETOR(S) – Guarantee’s are normally required
Name 1 Driv.Lic: D.O.B
Address State P/Code
Home / Property Own
Buying Renting 		Mkt Value: $ Mortgage:$
Date:
I confirm that the above information is true and correct and I accept the authorisations and agreements as set out above.

DETAILS OF DIRECTOR(S) / PARTNER(S) / PROPRIETOR(S) – Guarantee’s are normally required
Name 1 Driv.Lic: D.O.B
Address State P/Code
Home / Property Own
Buying Renting 		Mkt Value: $ Mortgage:$
Date:
I confirm that the above information is true and correct and I accept the authorisations and agreements as set out above.
Please complete the fields marked red