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Advance Business Finance
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INTRODUCER/DEALER/BROKER DETAILS

Introducer Name/Company

Introducer Contact Person

Contact Phone Number

*Contact Email

FINANCE DETAILS

* These fields are required

*Loan Amount $

*Finance Type

*Term

APPLICATION DETAILS

* These fields are required

Business Type


SOLE TRADER/SELF EMPLOYED DETAILS

*Occupation

*Name of Legal Entity in full

*ABN

* Street-number

*Street-name

*Suburb

*State

*Post Code

*Years Trading

 Years
 Months

*Previous Employer
(if less than 3 years trading)

*Number Employees

*Gross Income $

*Gross Profit $

   

EMPLOYED INDIVIDUAL

* Family-name

* First-name

Middle-name

* Gender

Male  Female

Current Residential

* Street-number

*Street-name

 *Suburb

* State

*Post Code

*Home Phone

*Work Phone

*Fax

*Mobile

*Occupation

*Employer

*Years Employed

 Years
 Months

*Previous Employer
(if less than 3 years trading)

*Gross Annual Salary$

* Drivers-license-number

* Date-of-birth

 Years
 Months
 Days

Email

*Name of Legal Entity in full


Please do not enter the organisation type i.e. Pty Ltd

*Nature of Business

*Australian Company Number (ACN)

*ABN

* Street-number

*Street-name

*Suburb

*State

*Post Code

Turnover $

*Number of Employees

*Years under current owner

 Years
 Months

Net Profit $


*Name of Contact

*Position

*Office Phone

Office Fax

*Mobile

Office Email

ADDITIONAL DETAILS

The following information is not compulsory, however, ABF may require these details at a later time and providing the information now may avoid future delays.

*Accountant Company Firm Name

*Contact Person

*Phone Number

*Authority to contact your accountant for information if required

 

     Yes          No


*Trade Reference 1

*Reference Phone

*Trade Reference 2

*Reference Phone

PERSONAL DETAILS – 1st PERSON

To be fully completed by directors/partners/individuals NOT required for government or top 500 companies

* Family-name

* First-name

Middle-name

*Gender

Male  Female

* Street-number

*Street-name

* Suburb

*State

* Post Code

*Drivers License

*Date of Birth

*Phone Number

*Annual Income

REAL ESTATE DETAILS

Are you a

Renter  or Home Owner

*Value $

*How long at current address

Years Months

*Previous Address
(if less than 3 years at current address)


Are There Any More Partners/Directors

Yes    No  

PERSONAL DETAILS – 2nd PERSON

To be fully completed by directors/partners/individuals NOT required for government or top 500 companies

* Family-name

* First-name

Middle-name

* Gender

Male  Female

* Street-number

*Street-name

* Suburb

* State

* Post Code

*Drivers License

*Date of Birth

*Phone Number

*Annual Income

REAL ESTATE DETAILS

*Address

Are you a

Renter  or Home Owner

*How long at current address

 Years
 Months

*Previous Address
(if less than 3 years at current address)

Are There Any More Partners/Directors

Yes    No  

PERSONAL DETAILS – 3rd PERSON

To be fully completed by directors/partners/individuals NOT required for government or top 500 companies

* Family-name

* First-name

Middle-name

* Gender

Male  Female

* Street-number

*Street-name

* Suburb

* State

*Post Code

*Drivers License

*Date of Birth

*Phone Number

*Annual Income

REAL ESTATE DETAILS
 

*Address

Are you a

Renter  or Home Owner

*How long at current address

 Years
 Months

*Previous Address
(if less than 3 years at current address)

Are There Any More Partners/Directors

Yes    No  

PERSONAL DETAILS – 4th PERSON

To be fully completed by directors/partners/individuals NOT required for government or top 500 companies

* Family-name

* First-name

Middle-name

* Gender

Male  Female

* Street-number

*Street-name

*Suburb

*State

*Post Code

*Drivers License

*Date of Birth

*Phone Number

*Annual Income

REAL ESTATE DETAILS
 

*Address

Are you a

Renter  or Home Owner

*How long at current address

 Years
 Months

*Previous Address
(if less than 3 years at current address)

Are There Any More Partners/Directors

Yes    No  

PERSONAL DETAILS – 5th PERSON

To be fully completed by directors/partners/individuals NOT required for government or top 500 companies

* Family-name

* First-name

Middle-name

* Gender

Male  Female

* Street-number

*Street-name

* Suburb

* State

* Post Code

*Drivers License

*Date of Birth

*Phone Number

*Annual Income

REAL ESTATE DETAILS
 

*Address

Are you a

Renter  or Home Owner

*How long at current address

 Years
 Months

*Previous Address
(if less than 3 years at current address)


 EQUIPMENT/ADVANCE DETAILS

*Equipment Description

*Reason for Equipment

*Supplier of Goods

*Sales Person

*Phone Number

* First Person

Yes      No  


PRIVACY AND CREDIT INFORMATION & PRIVACY ACT AUTHORISATION/AGREEMENT

I/We certify that the equipment will be used predominantly for business or investment purposes.

*   Second Person

Yes      No

*   Third Person

Yes      No

*   Fourth Person

Yes      No

*   Fifth Person

Yes      No


*First Person

I agree

Yes  

*Second Person

I agree    

Yes

*Third Person

I agree    

Yes

*Fourth Person

I agree    

Yes

*Fifth Person

I agree   

Yes
 
 
 
Advance Business Finance Pty Ltd ABN 28 114 212 672 Unit 1, 17 Hayling Street, Salisbury Qld 4107 PO Box 108, Salisbury Qld 4107
Phone: (07) 3710 9300 Fax: (07) 3255 6878  Email: reception@advancebusinessfinance.com.au   www.AdvanceBusinessFinance.com.au