Mimaki Application Form Step 1 of 3 33% Applicant Details Legal Name* Trading As Business 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.*Contact Mobile No.*A.C.N A.B.N* PhoneEmail* Website No. of Employees References Finance Reference Finance Reference Contact Number Supplier Details Supplier Equipment Description* Supplier PhoneSupplier Contact Name Supplier Contact Email Address Term (months) Monthly Payment Ex GST Asset 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: 2 GB.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 Name Driv. 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 ValueMortgageEmailThis field is for validation purposes and should be left unchanged.
