LFT - CONTRACTOR APPLICATION FORM
COMPANY NAME
ACN
*
ABN
*
Address
STREET ADDRESS
Street Address Line 2
SUBURB & Postcode
State / Province
Postal / Zip Code
Phone
*
Email Address
*
example@example.com
Company Director
*
Mobile
*
Email Address
*
example@example.com
Banking Details. Account
*
BSB No.
*
INSURANCE DETAILS
NB/You will also require the following documents on hand for uploading to our server once you have received your system log in details;
VEHICLE DETAILS
Please complete for each vehicle that will be working
for LFT
VEHCILE REGO
*
REGO EXPIRY DATE
*
/
Day
/
Month
Year
Date
YEAR MANUFACTUR
*
MAKE / MODEL
*
CAPACITY
*
NO. AXLES
*
GCM ( if applicable)
GVM
*
TARE
*
GAWR Rear
GAWR Front
Front Axle Payload
Rear Axle Payload
Please ensure you have the following documents readily available to upload into your Contractor Portal
Please tick if present and working. Receipts of service and maintenance will be required to upload to portal once set up.
Vehicle Base ( Suburb where vehicle is generally parked)
*
INSPECTION CARRIED OUT BY:
(Print Name)
*
Signature
*
Clear
Submit
Should be Empty: