Application to Assign Lease -

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Property Details:

Property ID*

Property Address*

Your Contact Details:

Registered Company Name

Contact Name*

Address

Postcode

Mobile Phone

Work Phone

Home Phone

ABN

ACN Number

Lease Details:

Proposed Lease Start Date*

Proposed Lease Length*

Proposed Rent Per Annum*

Lease Renewal Options

Proposed Use For Premises*

Does your proposed use supply goods or services to the public?*

Conditions

Your Trade Experience:

1. Company

1. Contact's Name

1. Contact's Phone

2. Company

2. Contact's Name

2. Contact's Phone

3. Company

3. Contact's Name

3. Contact's Phone

Current or Previous Landlord:

Landlord Company Name

Contact's Name

Contact's Phone

Finances:

Are you or any of your business partners an undischarged bankrupt or have any of you assigned your estate for the benefit of creditors or had a judgement record against you?*

Assets and Liabilities:

Value

2. Other Assets

Detail

Detail

Value

2. Other Liabilities

I/We hereby certify that the above information is true and correct as the date of this application and that the assets as stated are held solely by me/us and are not held in a trust capacity. *

Detail

Value

Existing Lease / Business Purchase:

Is this application for the purpose of signing an existing lease due to the purchase of a business?

If yes, what is the Settlement Date

If yes, who is your Solicitor / conveyancer handling the transaction?

Solicitor's Company Name

Solicitor's Contact Name

Business Phone

Mobile Phone

Identification:

Primary Documents You must provide at least one item from this primary list Current Passport Citizenship Certificate Birth Certificate Identification Cards You must provide at least one item from this identification list Current Drivers Licence Current Tertiary Education ID Current Identification Card Social Security, Health Care or Pension Card Secondary Documents *You must provide at least one item from this secondary list Written reference signed by an officer from a financial body where you have been a customer for a minimum of 12 months Verification from a local government officer who has known you for 12 months or more Name and address of signatory verified from mortgage documents Current credit and debit cards Medicare card Utility Bill Foreign Drivers Licence

In accordance with Section 18n(1) (b) of the Privacy Act I authorise you to give information to and obtain information from all credit providers and references named in this application. I understand this can include information about my credit worthiness, credit standing, credit history or credit capacity. I understand this information may be used to assess my application.I/We hereby certify that the above information is true and correct as the date of this application and that the assets as stated are held solely by me/us and are not held in a trust capacity.*