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1300 12 11 10
leasing@selfco.com.au
Suite 106, Macarthur Point, 25 Solent Circuit, Baulkham Hills NSW 2153
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Selfco Leasing
Financing solutions for Australian small businesses
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Step 1 of 4 - Broker Details
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Broker Company
Broker Contact
Email
*
Phone
*
Borrower Details
Borrowing Entity
Sole Trader
Partnership
Company
Trust
Borrower
Trust
Trading Name
ABN
Nature of Business
Trading Address
Guarantor Details - Director #1
Surname
Other Names
Drivers Licence
Exp
Card
DOB
Home Phone
Work Phone
Mobile Phone
Email
Residential Status
Own
Buying
Renting
Boarding
Residential Address
Landlord Details
Director #2
Surname
Other Names
Drivers Licence
Exp
Card
DOB
Home Phone
Work Phone
Mobile Phone
Email
Residential Status
Own
Buying
Renting
Boarding
Residential Address
Landlord Details
Attachments
Privacy Consent
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Broker Submission
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Quote / Invoice
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Drivers Licence
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Assets & Liabilities Statement
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Financials
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Other
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Finance Reference
Name of Lender
Financed Amount
Repayment
Date taken out
Transaction Details
Program
Lite Doc
No Doc
Full Doc
Equity Funding
Product
Chattel Mortgage
CHP
Lease
Rental
Cost (inc GST)
Term
Brokerage
Other
Deposit
Amount Financed
Residual / Balloon
Goods Description
Goods
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New
Used
Year
Make
Model
Description
Supplier
Contact
Phone
Name
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