Rent-to-Own Application Please fill in all the details below A. Finance Request Equipment Price (exclusive of GST)* * $ Equipment Type * ICT Equipment Solar Panel (s) Electric Vehicle EV Charging Station Welding Plant Drink Sytem Power Equipment ATV (All Terrain Vehicle) Generator Point Of Sale System (POS) Furniture HIVAC (High Value Asset Control) Machinery Other - Please Specify Below Please Specify if not listed B. Business Name And Address Legal Business Name * Business Address * Address 1 Address 2 City State/Province Zip/Postal Code Country C. Personal Contact Details Name * First Name Last Name Residential Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Date of Birth * MM DD YYYY Housing * Years & Months at Current Address Email * Mobile Phone * (###) ### #### Message * How did you hear about us? Existing Customer Dealer Referral Word of Mouth Google Search Equipment Guide Advert Facebook Other - Please Specify D. Privacy Act Declaration I/we confirm that the information provided on this application for a loan/credit facility is true and correct. The information may be used by Auckland Finance Ltd (AFL) to assess the application for facilities, and administer and manage any facilities provided to the applicant and I/we acknowledge it will form part of any loan agreement that may be entered into. AFL may disclose information about me to its related companies, agents or contractors for the above purposes. I/We authorise AFL to disclose information about me to credit reference agencies for the purpose of obtaining a credit report on me. Those credit reference agencies may retain that information and provide it to their customers who use their credit reporting services. AFL may obtain information and make such enquiries about me as AFL considers warranted from any source and credit reference agencies for the above purposes. Declaration * Please tick to confirm you have read and accept the above Privacy Act declaration I Accept Thank you!
