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Application

Personal Info

* Are you an existing client:

* First-Name:

* Last-Name:

* Your Email Address:

Gender:

* Mobile phone:

Home Phone:

* Street Address:

* Suburb:

* State:

* Postcode:

* How long at this address?

* Rented or Owned?

* Date of Birth:

* Driver’s Licence #:

*Please put N/A if you don’t have a drivers license

* Referred by

Item to rent 1:

Kitchen

  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Dishwasher
  • Dishwasher
  • Dishwasher
  • Dishwasher
  • Dishwasher
  • Dishwasher
  • Stove
  • Stove
  • Stove
  • Coffee Machine
  • Coffee Machine
  • Coffee Machine
  • Coffee Machine

Laundry

  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Dryer
  • Dryer
  • Dryer
  • Dryer
  • Dryer

Smartphones

  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone

Computers and iPads

  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads

Home Entertainment

  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment

Heating and Cooling

  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling

Fitness Equipment

  • Fitness Equipment
  • Fitness Equipment
  • Fitness Equipment
  • Fitness Equipment
  • Fitness Equipment
  • Fitness Equipment
  • Fitness Equipment

Furniture

  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture

Baby Equipment

  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment

Miscellaneous

  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous

 

Item to rent 2:

Kitchen

  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Fridge
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Freezer
  • Dishwasher
  • Dishwasher
  • Dishwasher
  • Dishwasher
  • Dishwasher
  • Dishwasher
  • Stove
  • Stove
  • Stove
  • Coffee Machine
  • Coffee Machine
  • Coffee Machine
  • Coffee Machine

Laundry

  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Washing Machine
  • Dryer
  • Dryer
  • Dryer
  • Dryer
  • Dryer

Smartphones

  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone
  • Smart Phone

Computers and iPads

  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads
  • Computers and iPads

Home Entertainment

  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment
  • Home Entertainment

Heating and Cooling

  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling
  • Heating and Cooling

Fitness Equipment

  • Fitness Equipment
  • Fitness Equipment
  • Fitness Equipment
  • Fitness Equipment
  • Fitness Equipment
  • Fitness Equipment
  • Fitness Equipment

Furniture

  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture
  • Furniture

Baby Equipment

  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment
  • Baby Equipment

Miscellaneous

  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous
  • Miscellaneous

 

Comments:


Profile

Centrelink?

Skip this step if you are NOT receiving Centrelink payments

CRN

Which Benefit?

Do you have any other centrepay Contracts? If yes, what are they?


Income / Expense

Put a zero if not applicable.

Fortnightly income

* Centrelink income?
$

* Wages?
$

* Other
$

Fortnightly expense

* House Rent / Mortgage
$

* Car repayments
$

* Loan repayments
$

* Other fixed expenses
$

* Other rental expenses
$

* General living expenses
$

Disposable
$

Is your financial situation likely to change in the foreseeable future?


Employment

Employer Name

Employer Phone

Employer Address

Current Position

Payslip Income & Annual Wage

Previous employer details if in current job less than 2 years


Documents

Skip this step is you prefer to send them later.
In order to receive final approval, you will need to provide a 3 months’ bank statement and 2 of the following documents:-

  1. Household Bills (Gas, Water, Electricity, Phone etc.)
  2. Centrelink Income Statement
  3. Driver’s License
  4. Pay slip
  5. Tenancy

You can either upload them now or wait until we call you to confirm everything.

Bank statement (3 months)

Bill 1 (Household bill, Centrelink Income Statement, Driver’s License, Payslip or Tenancy)

Bill 2 (Household bill, Centrelink Income Statement, Driver’s License, Payslip or Tenancy)

Please Note: Each file you upload must not exceed 2 MB in size. Otherwise it won’t be uploaded.


Residence

Real Estate / Landlord Name

Real Estate / Landlord Phone

Real Estate/Landlord Street Address

Your Last Address and Details if at above for less than 12 months


References

Personal References – not living with applicant

Reference 1

* Name

* Phone

* Address

* Relationship

Reference 2

* Name

* Phone

* Address

* Relationship

Reference 3

* Name

* Phone

* Address

* Relationship


Privacy Statement

Direct Appliance Rentals Privacy Statement:
Direct Appliance Rentals Pty Ltd (ACN 098 305 714) trading as Direct Appliance Rentals and its authorised representatives and franchisees (collectively Direct Appliance Rentals) is committed to ensuring the confidentiality and security of the personal information of its clients, and is also committed to complying with the Privacy Act 1988 (Cth) (which includes the Australian Privacy Principles) and the Anti Money Laundering and Counter Finance Terrorism Act 2006. The Direct Appliance Rentals Privacy Policy details our handling of personal information.

This application form will be processed by Direct Appliance Rentals and your eligibility for our credit product will be assessed based on the information you disclosed to us.

By submitting this application form, you consent to the collection, use and disclosure of your credit related information (as defined in our Privacy Policy) by Direct Appliance Rentals and or any of its authorised representatives and franchisees.

If you do not provide some or all of the information requested on our application form, we may not be able to accept your application or otherwise provide you with our services.

Direct Appliance Rentals may use information received from you to send marketing material to you from time to time unless you elect not to receive it. Direct Appliance Rentals will not provide your information to any third party other than in accordance with the Direct Appliance Rentals Privacy Policy.

I do not wish to receive any promotional material from Direct Appliance Rentals.


Electronic Communication please insert the below:

I / we the applicant/s consent to receiving of notices, credit disclosure documents, contract documents and other communications in connection with our dealings with Direct Appliance Rentals by email, other form of electronic communication or retrieval. My/our nominated email address for electronic communications is above OR [insert alternative email address below].

Alternate Email:

Terms & Conditions

By checking this box I indicate:

  1. I have read and understand the Privacy Policy
  2. I have read and understand the Electronic Authorisation Policy
  3. I can afford to make the fortnightly repayments
  4. I have read the Credit Guide and Information-Statement