Eftpos Helpdesk Limited

Rental Application
Choose your terminal Rental Term:
Equipment Cost: * Booking Fee:
Legal Name: * Trading As:
Company Number: Dealer:
Address of Business
Business PO Box: * Contact Email: *
Contact: * Phone: *
Nature of Business: * Years Established:
Director: Date of Birth:
Address
Director: Date of Birth:
Address:
Bank & Branch:
Accountant: Phone:
Insurer: Phone:
Trade Reference: Phone:
Trade Reference: Phone:

PRIVACY ACT REQUIREMENT

I/ We agree to Leasetech Ltd obtaining a report about our credit worthiness from a Credit Reporting Agency for the purpose of assessing our credit worthiness or collecting any overdue payments; in doing so I/ we acknowledge that the information from the application or concerning Leasetech Ltd’s credit provider status may be disclosed. I/ We also agree that Leasetech Ltd may give to or receive from another credit provider a report about my/ our credit worthiness for the purpose of assessing an application made by me/ us to another credit provider or collecting any payment that is overdue to a credit provider.


I Agree with the terms and conditions
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