Equipment Finance Pre-Approval Application Applicant DetailsTitle*MrMrsMsMissName First Last Date of Birth* DD MM YYYY Licence NumberPlease EnterPostcode*Mobile No.*Work No.Home No.Email* Equipment InformationAgriculturalComputers & I.T.EarthmovingBusiness Fit-OutsMachineryMedicalScientificOtherFinance RequestPurchase Price*Deposit Amount*Finance Amount*Your Income*Gross Income - (before Tax amount)Pay Frequency*Per WeekPer FortnightPer MonthAnnualFinance Term*6 Months12 Months2 Years3 Years4 Years5 YearsQuestionsWhere would you like to purchase from?ManufacturerWholesalerDealerBrokerPrivate SellerAuction (Traditional)Auction (Online)I'm not SureWould You Like Regent Finance to help you Find the Equipment?YesNoI'm Not SureHave You Ever Had or Applied for Finance Before*YesNoI'm Not SureAre You a Property Owner?*YesNoEmployment Status*Self-EmployedEmployee: Full-TimeEmployee: Part-TimeEmployee: CasualBrief Survey - How did you hear about us?DealerRadioRegent's WebsiteRegent's Facebook AdvertFriend/ReferralNewspaperSearch EngineAdditional CommentsMessage / RequestsPlease make sure that all details entered are correct. Then click on the "Apply Now" button below to submit your application. Stay tuned! Within 60 seconds, you will be notified on screen to let you know if you have been successful with your application. Good Luck!NameThis field is for validation purposes and should be left unchanged.