For a printable form, click here or fill out the online form below

Business Finance Application Form

PH: 03 572 7012
FAX: 03 572 7019

(Please write "N/A" if any information sought does not apply)

ALL SECTIONS MUST BE COMPLETED

COMPANY/ORGANISATION

Registered Company/Organisation Name: *
Company/Organisation Type	Company Incorporated Society Incorporated Charitable Trust Board Industrial Provident Society Trust Other
Trading Name :
GST No:
Company/Organisation Incorportation Date:
Company/Organisation No:
Began Trading?
Nature of Business:
Address: (Street)
Address: (postal)
Phone No:
Fax No:
E-mail Address:
Mobile No:
LTSA No:
Person Acting:
Contact Phone No:
Title:
Address:(if different from above)
E-mail Address:
PRINCIPAL DIRECTORS/SHAREHOLDERS
Principal Directors/Shareholders
Director/Shreholder?
Number of Shares
FINANCIAL ACCOUNTS/ACCOUNTANT
We appreciate that the following information is confidential, and so will be strictly treated accordingly.
Please attach a copy of your latest set of finaical accounts.
Have there been any materail changes in the financial standing of the company since these accounts were prepared? Y/N	Yes No
Accountant Company Name
Contact Person
Address
Phone No:
Fax No:
TRADE REFERENCES
Company
Contact Person
Phone Number
Document Attachments
Attachment 1
Attachment 2
Attachment 3
Attachment 4

Home About Services Applications Testimonials FAQ Contact FSCL Member