PTY.LTD.COY.

PUBLIC COMPANY PARTNERSHIP SOLE TRADER

Name A.C.N.
Address
Business/Profession Business Commenced
Business Contact Telephone
Accountant Telephone
Bank Branch
Trade References (i.e. Suppliers) Minimum 2 required
1 Telephone
2 Telephone
3 Telephone

Equipment 1
2
Amount $ 25,000
Supplier Details: Less Cash $ 5,000
Less T/IN $
Phone: Fax: Amount Financed $ 20,000
Lease/C.H.P. Period: 5 Years Months: 60 %RVS
Rate Installment $ +$ S/D=$

Director 1. ✔ INDIVIDUAL GUARANTOR

Name Aldem Al Talab
Address 61 Bonbin Rd, SADLEIR NSW 2168 Time at current address 3 Years 8 Mths
Previous Address Time at Previous address Years Mths
Home Telephone 0415 038 800 Business Telephone 02 9632 3888
Date of Birth 22/04/1984 Driver's Licence No. 13771610 Expiry Date
Married Widowed Single Separated ✔ Divorced
Occupation Sales Manager Income $ 65,000 No. of Deps 0
Employer SPARTON _ T/A Guildford Spares Time with Employer 3 Years 4 Mths
Previous Employer Time with Prev. Employer Years Mths
Spouse's Name D.O.B Driver's Licence No.
Spouse's Employer Time with Employer
Spouse's Occupation Income $
Spouse's Employer Time with Prev. Employer
Bank Branch
Home Owner/Buyers ✔ Parents/Relatives Renting Other Name of Landlord
Home Value Monthly Mortgage/Rent $

Director 1. INDIVIDUAL GUARANTOR

Name
Address Time at current address Years Mths
Previous Address Time at Previous address Years Mths
Home Telephone Business Telephone
Date of Birth Driver's Licence No.
Married Widowed Single Separated Divorced
Occupation Income $ No. of Deps
Employer Time with Employer Years Mths
Previous Employer Time with Prev. Employer Years Mths
Spouse's Name D.O.B Driver's Licence No.
Spouse's Employer Time with Employer
Spouse's Occupation Income $
Spouse's Employer Time with Prev. Employer
Bank Branch
Home Owner/Buyers Parents/Relatives Renting Other Name of Landlord
Home Value Monthly Mortgage/Rent $

Refinance Finance Company References

Company Account No. Mthly Term Date Commenced To be paid out Y / N

1
2
3
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PERSONAL STATEMENT OF ASSETS AND LIABILITIES
Name Aldem Al Talab DATE: 1 / 09 / 2009

LIABILITIES OWING ASSETS VALUE

Credit-________________(Limit $__________) Bank -Cheque A/C (s)

-________________(Limit $__________) -Saving /Access A/C (s)

$5,000
-________________(Limit $__--_______) -Other(Term deposits et]c

MORTGAGE | Monthly Repayment Shares

1 |
|
2 | HOME PROPERTY
| Address
3 |
|
OTHER PROPERTIES| Weekly
OTHER | Rental Income
MORTGAGES | Monthly Repayment |
| |
| |
| |
| MOTOR VEHICLES
| Year Make Model
2002 Toyota $5,000
OTHER LOANS | Monthly Repayment Year Make Model
|
| Caravan
| Boat
| Furniture & household effects
| Home Content 60,000
|
|
| OTHER ASSETS
|
|
|
|
|
|
|
|
|
|

TOTAL LIABILITIES $
Surplus
Total(to agree with Total Assts) Total Assets $ 70,000

I/We the undersigned herby acknowledge that we are not undischarged bankrupts and that the above information is true and correct

Name: Aldem Al Talab Signature

Signature

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Esanda Finance Coporation Limited A 424574
ABN 64 004 346 043

PRIVACY ACT 1988

PRIVACY INFORMATION AND AFREEMENT

Agreement by Applicant/s

1 Esanda may give a credit reporting agency certain personal information about me/au, including:
• Such permitted particulars about me/us which allow me/us to be identified;
• That I/We have applied for finance and the amount;
• That Esanda is a current credit provider to me/us or has ceased to be a current credit provider to me/us;
• Payments which are overdue more than 60 days, and for which collection action has commenced;
• Advice that payment are no longer overdue;
• Cheques draw by me/us for $10.00 or more which have been dishonored more than once;
• In specified circumstances, that in the opinion of Esanda, I/we have committed a serious credit infringement;

2 Esanda may obtain a report about my/our commercial activities or commercial a serious worthiness from a business
which provides information about the commercial credit worthiness of person for the purpose of assessing my/our
application for personal credit.

3 Esanda may abtian from a credit reporting agency a credit report containing personal information about me/us for the
purpose of assessing my/our application for commercial credit.

4 Esanda may give to and obtian from another credit provider information about my/our personal or commercial credit
arrangements for the purposes of assessing my/our finance application or credit worthiness, of collecting overdue

include any information about my/our credit worthiness, credit standing, credit history or credit capacity that credit
providers are allowed to exchange under the Priacy Act.

5 Esanda May give to a person who is acting as its agent in performing, on its behalf, a task that is necessary in
processing my/our application for finance or in managing a loan made by Esanda to me/us information about my/our
personal or commercial credit arrangements for the purpose of information me/us of any matter concerning that
application or that loan.

6 Esanda may disclose to a guarantor credit information relating to me/us and may also provide such information to a
person who is considering whether to become a guarantor, for that purpose.

7 If my/our application for credit is not completed within 14 days, Esanda may give ca credit reporting agency further
personal information about me/us in order to obtain a credit report about me/us.

Dated: / /

Signed

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