Mimaki Application Form Step 1 of 3 33% Applicant Details Legal Name*Trading AsBusiness Address* Street Address Address Line 2 City State Post Code Postal Address the same as Business Address? Yes No Postal Address Street Address Address Line 2 City State Post Code Nature of Business*Years Est.*ContactMobile No.*A.C.NA.B.N*PhoneEmail* WebsiteNo. of Employees References Finance ReferenceFinance Reference Contact NumberSupplier Details SupplierEquipment Description*Supplier PhoneSupplier Contact NameSupplier Contact Email AddressTerm (months)Monthly Payment Ex GSTAsset Cost (If applicable)Product Type Rental Lease Chattel Mortgage Details of Directors / Partners / Proprietors Name*Driv. Lic.*DOB* Day Month Year Are you an Australian citizen or permanent resident?NoYesPlease Upload Front of Drivers License* Drop files here or Select files Accepted file types: jpg, gif, png, pdf, jpeg, tiff, Max. file size: 40 MB, Max. files: 4. Please Upload Back of Drivers License* Drop files here or Select files Accepted file types: jpg, gif, png, pdf, jpeg, tiff, Max. file size: 40 MB, Max. files: 4. Medicare CardMax. file size: 256 MB.Home Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email* Years at Property*Previous Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Do you own your home or property?* Own Renting Market ValueMortgageIs there a second Director / Partner? Yes No NameDriv. Lic.DOB Day Month Year Home Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Years at Property*Previous Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Do you own your home or property? Own Renting Market ValueMortgageX/TwitterThis field is for validation purposes and should be left unchanged.
