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EQUIPMENT FINANCE APPLICATION
Director’s / Partner’s / Proprietor’s Details
I have read and agree with the above Authority to Collect and Disclose Personal
Information:
Yes
No *required.
First Name
Required
Middle Name
Surname
Required
Driver’s Licence No
Required
Residential Address
Address
Required
Town/ Suburb
Required
State
Required
Postcode
Required
Premises / Residence Owned
If Owned Market Value $
Required
Mortgage Amount $
Required
Time at Current Location
Required
First Name
Required
Middle Name
Surname
Required
Driver’s Licence No
Required
Residential Address
Address
Required
Town/ Suburb
Required
State
Required
Postcode
Required
Premises / Residence Owned
If Owned Market Value $
Required
Mortgage Amount $
Required
Time at Current Location
Required
_____________________________________________________________________
Rent Purchase
Lease Rent
Chattel Mortgage required
_____________________________________________________________________
Applicant Details
Business Type
Company
Partnership
Sole Trader required
Legal Name
Required
Trading Name
Required
ABN
Required
Rivwest Finance Limited A.C.N. 073 358 666 ABN 85 073 358 666
31 Talbragar Street, Dubbo NSW 2830 Phone: (02) 6882 0090
PO Box 1192, Dubbo NSW 2830
Email: admin@rivwest.com
Fax: (02) 6884 7628
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_____________________________________________________________________
Contact Details
First Name
Required
Last Name
Required
Phone
Required
Fax
Email
___________________________________________________________________
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