Flexirent Capital Pty Ltd
ABN 93 064 046 046
Australian Credit Licence number 394735 (Flexirent)

Locked Bag 5005 Royal Exchange

Sydney, NSW 1225 Australia

P: 1800 240 102

F: 02 8905 1822

${letterTodayDate}

Dear ${letterDisplayName},

Re: Your Rental Agreement Number ${originalAccountNumber} (Application ID: ${asmtAppID})

We refer to the letter sent to you on the ${hshipEntryDate} in relations to you request for Financial hardship assistance under your Rental Agreement.

We regret to inform you that we are currently unable to progress the assessment of your application without receiving further supporting documentation from you.

In order for us to assess your current situation, there are three actions we need you to do. These are:

1.	Review the Assessment Notice for any discrepancies in your original application (copy attached);
2.	Complete the Statement of Financial Position (copy attached); and
3.	Attach any supporting documents and any additional information you believe may be relevant in assisting us to correctly assess your position.

So we can assess how best to assist you, please review the information contained within the Assessment Notice and let us know if there were any errors/discrepancies at the time of your application.

Please note that it is important that you review the Assessment Notice and notify us of any inconsistencies, as it may have significant impact on the outcome of your application.

You have twenty-one (21) days from the date of this letter to provide the above information. If we require further supporting documentation to assess your situation, we will provide you with more time to do so.

If you would like to discuss any of the above, please feel free to contact us direct on any of the below options:

•	Phone: 1800 240 102
•	Fax: 02 8905 1822
•	Email: CustomerRelations.Hardship@flexigroup.com.au

Your sincerely,

Customer Relations - Financial Hardship

Assessment Notice

The following information provides a summary of information provided to us (including your answers to questions we asked you) at the time of your application for a consumer lease. Please contact us if you believe there are any errors/discrepancies within your original application.

Date of Application

DD/MMM/YYYY

CUSTOMER DETAILS

Name	${asmtCustomerName}
Date of Birth	${displayAsmtDateOfBirth}

REQUIREMENTS AND OBJECTIVES

Question

Your Answer

You understand that you are applying for a fixed term consumer lease agreement?

I understand.

You understand that you do not retain ownership of the goods at the end of the agreement, however you may:

•	ask us to accept your offer to purchase the goods;
•	continue to rent on an ongoing monthly basis;
•	return the goods and terminate the agreement; or
•	apply to upgrade to new goods(subject to our credit criteria).

I understand.

What is the primary intended purpose of your use of the goods under this Rental Agreement (Business/Personal)?

Predominantly for personal use.

PRIVACY

Question	Your Answer
You consent to Flexirent exchanging information about you with credit reporting bodies, banks, other financial institutions, persons mentioned in this rental application, our corporations in Australia and overseas and to assess your application?	I consent
You consent to Flexirent confirming your income details with any employers mentioned in this application?	I consent

PRODUCT DETAILS

Product Type	Consumer Lease
Credit Limit	$3963.74
Total Monthly Rental	$192.24 per month
Term	36 months

CUSTOMER FINANCIAL INFORMATION

*Residential details*	Residential Status	Boarding
	Monthly amount	651.79
	Name on Lease	Yes
	Length at address	7 years
	Previous address	N/A

*Employment and income*	Type	Employed – Full Time
	Employer Name	Mine Site Construction Services
	Job Title	Truck Driver
	Job Classification	trade
	Yearly Amount	88169.84
	Length of Employment	1 years and 6 months
	Previous - Income Source	N/A
	Previous - Length of Time	N/A
	ABN	N/A
	Trading Time	N/A
	Turnover	0.00
	Net Profit	0.00
	Director's Salary	0.00
	Time as Director	N/A

*Other income*	Spouse Income	0.00
	Family Tax Benefit Income	0.00
	Government Benefits	0.00
	Superannuation	0.00
	Child Support	0.00
	Investment - Rental Property/Dividends	0.00
	Interest Income	0.00
	Other Income	0.00

*Expenses and liabilities*	Expense/Liability	Monthly Amount
	Rent	0.00
	Business loan	0.00
	Personal loan	0.00
	Car lease	0.00
	Car loan	0.00
	Line of credit	0.00
	Other Debt	0.00
	Other mortgage	0.00
	Store card	0.00
	Household & Living Expenses	0.00
	Number of Credit Cards	0.00
	Combined Limit	0.00
	Total

*Other relevant information*	Credit checks	N/A
	Number of dependents	0.00
	Any other relevant information	0.00

Additional documentation used for assessment

N/A

SUITABILITY ASSESSMENT

Our Assessment

Not Unsuitable

Customer's requirements and objectives

We understood that your Requirements and Objectives were to enter into a fixed term consumer lease agreement to rent the goods predominantly for personal use.

Based on the information you supplied to us at the time, our assessment was that:

(a)	You were able to comply with financial obligations under the consumer leaseagreement without hardship; and
(b)	The consumer lease agreement met your Requirements and Objectives.

Statement of Financial Position

Contract Number(s):

Surname:

Given Name(s):

Date of Birth:

Residential Address:

Telephone: Home:

Work:

Mobile:

Occupation:

Employer:

Spouse's Full Name:

Spouse's Occupation:

Employer:

Date of Birth:

Number of dependents:

Maiden Name:

Monthly Income
Your Net Take Home Pay:		$
Your Other Regular Income:		$
Spouse's Net Take Home Pay:		$
Centrelink Family Payment:		$
Child Maintenance:		$

Other Income Not Specified Above:
		$
		$
		$

Total Monthly Income		$

Assets		Value
Home:		$
Other Real Estate:		$
Home Contents:		$
Motor Vehicle:		$
Registraion Number:		$
Cash at Bank:		$
Other (Please Specify)
		$
		$
		$

Total Assets	$	$

Expenses		Monthly Payments
Mortagage:		$
Rent:		$
Landlord/Agent Tel No.		$
Electricity:		$
Gas:		$
Telephone:		$
Rates:		$
School Fees:		$
Travel Expenses:		$
Entertainment:		$
Food:		$
Insurance (divide yearly amount by 12):
Home Contents		$
House		$
Car		$
Other
Car Registration(divide yearly amountby 12):		$
Maintenance:		$
Childcare:		$

Other Expenses (Please Specify)
		$
		$
		$

Total Expenses		$

Liabilities		Balance

Car:	$	$
Flexirent Contract(s)	$	$

Credit Cards (please specify)
	$	$
	$	$
	$	$

Other Liabilities Not Specified
	$	$
	$	$
	$	$

Total Expenses & Liabilities	$	$

Proposed Payment Plan

In your own words, please briefly outline a payment plan you are able to maintain under this hardship arrangement. This will assist us in tailoring a best possible solution for you.

Where possible, please provide specific date ranges (e.g. if you are seeking a period of relief, provide the dates during which you are unable to meet your payment obligations).

If you require more space, please attach any additional pages to the end of this document.

By signing below, you acknowledge that:

> The information submitted within this form is true and accurate (to the best of my knowledge);
> Flexirent will assess my hardship application based on the information (and any supporting documentation);
> Flexirent may request further supporting documentation to verify the accuracy of the above information; and
> Flexirent's Financial Hardship team may further contact you to discuss your application.

	Customer Name	____________________
	Customer Signature	____________________	Date _____ / _____ / ________

Flexirent Capital Pty Ltd ABN 93 064 046 046 is the financier and holds the Australian Credit Licence number 394735 (Flexirent).

FlexiRent®, FlexiWay®, SmartWay® and Lisa. are trademarks of Flexirent, a subsidiary of FlexiGroup Limited.