Finance Company Web and PDF Form

i need an application form for my finance company that i can send to brokers, i need it as a web form and pdf. see details below. needs to have In2capital pty ltd branding. which I can upload. * Asset details * Supplier/vendor details * Existing equipment liabilities * Insurance information * Personal Asset & Liability Statement (if required) * Privacy consent & declarations # **Business Lending & Asset Finance Application Form** --- # **1. Broker Information** * **Broker Name:** __________________________________________ * **Broker Company:** ________________________________________ * **Aggregator (if applicable):** ________________________________ * **Email:** ________________________________________________ * **Phone Number:** _________________________________________ * **ACL Number (if applicable):** _______________________________ * **Broker Fee (if applicable):** ________________________________ * **Notes / Additional Information:** _____________________________ --- # **2. Type of Facility Required** Tick one or more: * □ **Business Loan** * □ **Business Mortgage** * □ **Line of Credit** * □ **Bridging Loan** * □ **Asset Finance – Chattel Mortgage** * □ **Asset Finance – Lease** * □ **Asset Line Facility** * □ **Other (specify):** _________________________________________ **Purpose of the Loan / Facility:** --- **Amount Requested:** _______________________________________ --- # **3. Borrowing Entity Details** **Legal Entity Type:** □ Company □ Trust – specify trust structure: _______________________________ □ Partnership □ Sole Trader **Legal Entity Name:** _________________________________________ **Trading Name:** _____________________________________________ **ABN / ACN:** _______________________________________________ **Industry:** _________________________________________________ ### **Directors / Owners** 1. --- 2. --- 3. --- ### **Business Contact Details** **Business Address:** ____________________________________________ --- **Business Phone:** _____________________________________________ **Email:** ______________________________________________________ ### **Business Financial Summary** **Annual Turnover:** ____________________________________________ **Years Trading:** _______________________________________________ **Existing Business Liabilities:** * Lender: _______________________ Balance: ______________________ * Lender: _______________________ Balance: ______________________ * Lender: _______________________ Balance: ______________________ --- # **4. Asset Finance / Asset Line Facility Section** ## **4.1 Details of Asset(s) Being Financed** (For Asset Finance or Asset Line Drawdown) * **Asset Type:** _____________________________________________ * **Make / Model:** ___________________________________________ * **Year:** ___________________ * **New or Used:** ____________________________________________ * **VIN / Serial Number (if applicable):** __________________________ * **Asset Location:** ___________________________________________ * **Purchase Price (GST incl.):** ________________________________ * **Deposit (if any):** __________________________________________ * **Term Requested:** __________________________________________ --- ## **4.2 Supplier / Vendor Details** * **Supplier Name:** __________________________________________ * **Contact Person:** __________________________________________ * **Phone:** _________________________________________________ * **Email:** _________________________________________________ * **Quote / Invoice Number:** __________________________________ * **Is the supplier related to the borrower?** □ Yes □ No If yes, explain: _______________________________________________ --- ## **4.3 Existing Equipment Liabilities** (For Asset Line – refinancing or payout figures) * Equipment Loan / Lease Provider: _____________________________ **Balance Owing:** ______________________ * Equipment Loan / Lease Provider: _____________________________ **Balance Owing:** ______________________ --- ## **4.4 Insurance Details** * **Do you have insurance for the asset(s)?** □ Yes □ No * **Insurer Name:** __________________________________________ * **Policy Number:** __________________________________________ * **Expiry Date:** _____________________________________________ * **Type of Cover:** ___________________________________________ --- # **5. Property Security (if applicable)** **Property Address:** _____________________________________________ --- **Ownership:** □ Borrowing Entity □ Director □ Related Party (specify): _______________________________________ **Estimated Value:** ______________________________________________ **Liabilities Against Property:** * Lender: ________________________ Balance: _______________________ * Lender: ________________________ Balance: _______________________ --- # **6. Personal Asset & Liability Statement** *(Required for directors, guarantors, or if asset-backed facility)* ### **Assets** * Property (address): __________________________________ Value: __________ * Motor Vehicles: _____________________________________ Value: __________ * Savings / Cash: _____________________________________ Value: __________ * Shares / Investments: ________________________________ Value: __________ * Other Assets: ________________________________________ Value: __________ ### **Liabilities** * Home Loan: _________________________________________ Balance: _________ * Personal Loans: _____________________________________ Balance: _________ * Credit Cards: _______________________________________ Balance: _________ * Other Liabilities: ____________________________________ Balance: _________ --- # **7. Supporting Documents Required** Please provide the following (where applicable): * Identification for all directors / owners * Trust deed (if borrowing under a trust) * 6–12 months business bank statements * Financial statements (if available) * Asset invoice or supplier quote * Property rates notice or valuation (if property security offered) * Current insurance certificate --- # **8. Declarations & Consents** The applicant acknowledges and agrees: * All information provided is true and correct. * The lender may verify information with third parties. * Credit checks may be performed on the entity and its directors. * The lender may request additional information if required. **Director / Applicant Signature:** ____________________________ **Name:** _________________________________________________ **Date:** _________________________________________________ --- If you'd like, I can now: Turn this into a professionally formatted Word document and pdf and web page Create a fillable PDF form Add **your branding, logo, and colours**

Proje No: 40037644