Client Equipement Lease Application

Equipment lease agreement for business purposes

Date *

Leasing Agent: GC Leasing Sydney Pty Ltd

Applicant Information

Trading Name *

Contact Person *

ABN / ACN *

Phone *

Email *

Trading Address *

Address Line 1

City

State / Province / Region

Postal Code

Partners / Directors / Shareholders / Guarantors

Full Name *

Title or Position *

Home Address *

Address Line 1

City

State / Province / Region

Postal Code

Mobile Number *

Email Address *

Driver's License Numbers *

Driver's License Expiry Date *

Copy of Driver's License (Front View) *

Click or drag a file to this area to upload.

(Important Note: Please provide or attached a copy of the front and back view of the drivers license with this application)

Copy of Driver's License (Back View) *

Click or drag a file to this area to upload.

(Important Note: Please provide or attached a copy of the front and back view of the drivers license with this application)

Copy of Business Card (Front View) *

Click or drag a file to this area to upload.

(Important Note: Please provide or attached a copy of the front of your business card)

Copy of Business Card (Back View)

Click or drag a file to this area to upload.

(Important Note: Please provide or attached a copy of the back of your business card - IF AVAILABLE)

Leasing Rates (Office Use Only)

Monthly Charges (ex. GST) *

$ 0.00

Monthly Charges (ex. GST) *

Dropdown *

CPD Quote # *

Your Quote number / Reference

DECLERATION

Privacy Act Declaration and Authorisation to release financial information: *

I/we hereby certify that the information provided is true. Under the privacy act 1988, I/we authorize POS Direct Pty Ltd (ABN: 68 618 244 796) and GC Leasing Sydney Pty Ltd t/as Grenke (ABN 27 615 226 045) to collect and provide to credit reporting agencies personal information and to seek consumer credit reference reports to assess this application. You authorise the Recipients to give and obtain from other credit providers information about your credit worthiness, credit standing, credit history or credit capacity. I/we acknowledge that the credit applied for may be provided by another credit provider and in such cases CPD may disclose personal information to such credit providers for the purposes of assessing this application. If you would like to know more about the personal information which the Recipients hold about you or the Recipients handling of personal information about you please contact CPD on 1300 767 303 or email accounts@posdirect.com.au

Applicant 1 - Full Name *

Signature *

Date *

Applicant 2 - Full Name *

Signature *

Date *

Name