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Application

STEP 1 – Contact Details

* 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?
Rented Owned
* DOB

* Driver’s Licence #

* Referred by

Item to rent 1:

Kitchen

  • Dishwasher
  • Top mount Fridge
  • Bottom mount Fridge
  • Side by Side Fridge
  • Small 200-380 Litre Fridge
  • Medium 350-530 Litre Fridge
  • Large 440 Litre + Fridge
  • Small Chest Freezer
  • Medium Chest Freezer
  • Large Chest Freezer
  • Medium Vertical Freezer
  • Large Vertical Freezer
  • Gas Cooker
  • Electric Cooker

Laundry

  • Medium top loading washer
  • Large-top-loading-washer
  • Medium front loading washer
  • Large front loading washer
  • Clothes Dryer

Smartphones

  • iPhone 5S 16Gb
  • iPhone 6 16Gb
  • iPhone 6 plus
  • Samsung Galaxy SIII
  • Samsung Galaxy S4
  • Samsung Galaxy S5
  • new s6
    Samsung Galaxy S6
  • SAMSUNG S6 Edge
    Samsung Galaxy S6 Edge
  • Samsung Galaxy Note 3
  • Samsung Galaxy Note 4

Computers

  • Entry level desktop PC
  • Mid level desktop PC,
  • Core i3 Laptop
  • Core i5 Laptop
  • Macbook Air
  • Macbook Pro
  • Apple iPad
  • Apple iPad Mini

Home Entertainment

  • 32″ LED Televisions
  • 42″ LED Televisions
  • 50″ LED Televisions
  • 55″ LED Televisions
  • Home Theatre and Surround Sound Systems
  • Xbox One (500GB)
  • Xbox 360 (250GB)
  • Sony Playstation 4 (500GB)
  • Sony Playstation 3 (500Gb)

Heating and Cooling

  • Portable Air Conditioner 2.8kw
  • Portable Air Conditioner 3.5kw
  • Sit-In Window Air Conditioner 2.5kw
  • Sit-In Window Air Conditioner 2.7kw
  • Split-system Air Con 2.5kw
  • Split-system Air Con 3.5kw
  • Split-system Air Con 5kw
  • Electric Portable Panel Heater
  • Gas Heaters

Fitness Equipment

  • Treadmills
  • Exercise Bikes
  • Rowers

Furniture

  • Single Bed
  • Double Bed
  • Queen Bed
  • King Bed
  • Bunk Bed
  • Lounge Room Furniture
  • Dining Room Furniture

Baby Equipment

  • Complete Package
  • Items
  • prams
    Pram

Miscellaneous

  • Vacuum Cleaners
  • Digital SLR Camera Nikon body
  • Digital SLR Camera Canon 18MP twin lens kit
  • Digital SLR Camera Sony with lens kit
  • lawn mower
  • SATALITE SCOOTER Satellite Scooter
  • GALAXY SCOOTER Galaxy Scooter

 

Item to rent 2:

Kitchen

  • Dishwasher
  • Top mount Fridge
  • Bottom mount Fridge
  • Side by Side Fridge
  • Small 200-380 Litre Fridge
  • Medium 350-530 Litre Fridge
  • Large 440 Litre + Fridge
  • Small Chest Freezer
  • Medium Chest Freezer
  • Large Chest Freezer
  • Medium Vertical Freezer
  • Large Vertical Freezer
  • Gas Cooker
  • Electric Cooker

Laundry

  • Medium top loading washer
  • Large-top-loading-washer
  • Medium front loading washer
  • Large front loading washer
  • Clothes Dryer

Smartphones

  • iPhone 5S 16Gb
  • iPhone 6 16Gb
  • iPhone 6 plus
  • Samsung Galaxy SIII
  • Samsung Galaxy S4
  • Samsung Galaxy S5
  • new s6
    Samsung Galaxy S6
  • SAMSUNG S6 Edge
    Samsung Galaxy S6 Edge
  • Samsung Galaxy Note 3
  • Samsung Galaxy Note 4

Computers

  • Entry level desktop PC
  • Mid level desktop PC,
  • Core i3 Laptop
  • Core i5 Laptop
  • Macbook Air
  • Macbook Pro
  • Apple iPad
  • Apple iPad Mini

Home Entertainment

  • 32″ LED Televisions
  • 42″ LED Televisions
  • 50″ LED Televisions
  • 55″ LED Televisions
  • Home Theatre and Surround Sound Systems
  • Xbox One (500GB)
  • Xbox 360 (250GB)
  • Sony Playstation 4 (500GB)
  • Sony Playstation 3 (500Gb)

Heating and Cooling

  • Portable Air Conditioner 2.8kw
  • Portable Air Conditioner 3.5kw
  • Sit-In Window Air Conditioner 2.5kw
  • Sit-In Window Air Conditioner 2.7kw
  • Split-system Air Con 2.5kw
  • Split-system Air Con 3.5kw
  • Split-system Air Con 5kw
  • Electric Portable Panel Heater
  • Gas Heaters

Fitness Equipment

  • Treadmills
  • Exercise Bikes
  • Rowers

Furniture

  • Single Bed
  • Double Bed
  • Queen Bed
  • King Bed
  • Bunk Bed
  • Lounge Room Furniture
  • Dining Room Furniture

Baby Equipment

  • Complete Package
  • Items
  • prams
    Pram

Miscellaneous

  • Vacuum Cleaners
  • Digital SLR Camera Nikon body
  • Digital SLR Camera Canon 18MP twin lens kit
  • Digital SLR Camera Sony with lens kit
  • lawn mower
  • SATALITE SCOOTER
     Satellite Scooter
  • GALAXY SCOOTER
     Galaxy Scooter

 

Comments:


Step 2 – 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?


Step 3 – 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?


Step 4 – Employment

Employer Name

Employer Phone

Employer Address

Current Position

Payslip Income & Annual Wage

Previous employer details if in current job less than 2 years


Step 5 – Documents

Skip this step is you prefer to send them later.
In order to receive final approval, you will need to submit a 3 month bank statement and 2 x bills. You can either upload them now or wait until we call you to confirm everything.

Bank statement (3 months)

Bill 1 (Phone, Electricity, Gas)

Bill 2 (Phone, Electricity, Gas)

Please Note: Each file you upload must not exceed 2 MB in size.


Step 6 – 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


STEP 7 – Personal References – not living with applicant

Reference 1

* Name

* Phone

* Address

* Relationship

Reference 2

* Name

* Phone

* Address

* Relationship

Reference 3

* Name

* Phone

* Address

* Relationship


Step 8 – 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.


STEP 9 – 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