15/08/2016 admin Rent to Own Application Form 1 Starting Information2 Business Details3 About You4 Income, Assets and Liabilites5 Finishing Up I have been talking to:*SelectDanielMardiKatDougHaydenOtherI have not spoken to anyone at Rideshare Solutions yetWho?*My budget is:*WeeklyVehicle Purchase PriceVehicle Purchase Price*AmountAmount*per weekPreferred vehicle:* Business DetailsBusiness Type*Sole TraderPartnershipPty Ltd CompanyOtherIf other:*ABNACN (if applicable)Business Name*Trading NameNature of BusinessWhat is your business going to do?Phone Number*Business Physical Address* Street Address City State / Province / Region ZIP / Postal Code Business Postal Address* Street Address City State / Province / Region ZIP / Postal Code IncomeAnnual Sales Estimate*Annual Net Profit* 1st DirectorPersonal DetailsFull Name* First Last Email* Enter Email Confirm Email Gender*MaleFemaleDate of Birth* Date Format: DD slash MM slash YYYY Mobile Number*Home NumberWork NumberDrivers LicenceLicence Number*Expiry Date*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920State*QLDNSWNTACTWATASVICSAAcquired Date*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ResidencyResidency Status*Australian Permanent ResidentNon-Permanent ResidentMarital Status*MarriedDivorcedWidowedSingleDefactoOtherDependants*None12345678910Residential Details - Current AddressProperty Address* Street Address City State / Province / Region ZIP / Postal Code If at current address for under 3 years, what was your previous address Street Address City State / Province / Region ZIP / Postal Code Residential Status*RentingOwn PropertyMortgagedLiving with ParentsBoardingOtherWeekly Rent/Board*Real Estate/Complex Manager Name*Parent Name* First Last Parent Contact Phone*If other:*Years living at address*1234567891011+Landlord Name* First Last Landlord Phone Number* Additional IncomeDo you receive additional income from any source?*YesNoDescription*Value*Frequency*WeeklyFortnightlyMonthlyTell us about your Assets & LiabilitiesWhat assets and liabilities do you have? Tick all that apply Property / Mortgage Investment Property Motor Vehicle Personal Loan Credit Card Shares Property / MortgageWhat's the value of the property?What are the monthly repayments?How much is owing?Investment Property:What's the value of the property?How much is owing?What are the monthly repayments?How many motor vehicles do you have?12More than 2Motor Vehicle 1:What's the current value?How much is owing?What are the monthly repayments?Who is the loan with?Motor Vehicle 2:What's the current value?How much is owing?What are the monthly repayments?Who is the loan with?Personal Loans:Who's the financier?How much is owing?What are the monthly repayments?How many credit cards do you have?Select12More than 2Credit Card:Who's the financier?What's the credit card limit?How much is owing on the credit card?Credit Card 2:Who's the financier?What's the credit card limit?How much is owing on the credit card?Shares:What's the total value of your shares?Personal & Houshold Effects:What's the total value?Cash In Bank:What's the total value?Superannuation:What's the total value?What are your weekly living expenses?Food and Beverage*Utilities - Elecricity, Rates etc.*Communication - Phone, Internet, Cable TV, etc.*Childcare and Education*Travel and Transport - Including new asset, rego, petrol, bus/train fares etc.*Insurance - including proposed asset, CTP, building, contents, health, income protection etc.*OtherPlease describe the other expenses (if anything was entered into "Other")Total per weekDirect Debit DetailsFinancial Institution*Account Name*BSB*Format 123-456Account Number* SignatureSignature*References - First RefereeFull Name* First Last Phone Number*Relationship*Address* Street Address City State / Province / Region ZIP / Postal Code Please read the Statement by applicant(s) for credit Please Confirm* I have read, understood and accept the statement by applicant(s) for credit ****PLEASE NOTE**** Once you press the submit button you will be redirected to a secure bank statement link that will automatically send 90 days of bank statements to us as part of your application. Rest assured this is a totally secure process and no login details are retained anywhere on your application.