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Step 1 of 5 - Initial Details
20%
Are you aged 18 years or above?
*
Yes
No
Unfortunately we won’t be able to assist you on this occasion.
Do you have a taxable income of at least €15,000 per annum?
*
Yes
No
Unfortunately we won’t be able to assist you on this occasion.
Citizenship
*
Irish
Other
Your Citizenship
*
Afghan
Albanian
Algerian
American
Andorran
Angolan
Antiguans
Argentinean
Armenian
Australian
Austrian
Azerbaijani
Bahamian
Bahraini
Bangladeshi
Barbadian
Barbudans
Batswana
Belarusian
Belgian
Belizean
Beninese
Bhutanese
Bolivian
Bosnian
Brazilian
British
Bruneian
Bulgarian
Burkinabe
Burmese
Burundian
Cambodian
Cameroonian
Canadian
Cape Verdean
Central African
Chadian
Chilean
Chinese
Colombian
Comoran
Congolese
Congolese
Costa Rican
Croatian
Cuban
Cypriot
Czech
Danish
Djibouti
Dominican
Dominican
Dutch
East Timorese
Ecuadorean
Egyptian
Emirian
Equatorial Guinean
Eritrean
Estonian
Ethiopian
Fijian
Filipino
Finnish
French
Gabonese
Gambian
Georgian
German
Ghanaian
Greek
Grenadian
Guatemalan
Guinea-Bissauan
Guinean
Guyanese
Haitian
Herzegovinian
Honduran
Hungarian
I-Kiribati
Icelander
Indian
Indonesian
Iranian
Iraqi
Israeli
Italian
Ivorian
Jamaican
Japanese
Jordanian
Kazakhstani
Kenyan
Kittian and Nevisian
Kuwaiti
Kyrgyz
Laotian
Latvian
Lebanese
Liberian
Libyan
Liechtensteiner
Lithuanian
Luxembourger
Macedonian
Malagasy
Malawian
Malaysian
Maldivan
Malian
Maltese
Marshallese
Mauritanian
Mauritian
Mexican
Micronesian
Moldovan
Monacan
Mongolian
Moroccan
Mosotho
Motswana
Mozambican
Namibian
Nauruan
Nepalese
Netherlander
New Zealander
Ni-Vanuatu
Nicaraguan
Nigerian
Nigerien
North Korean
Northern Irish
Norwegian
Omani
Pakistani
Palauan
Panamanian
Papua New Guinean
Paraguayan
Peruvian
Polish
Portuguese
Qatari
Romanian
Russian
Rwandan
Saint Lucian
Salvadoran
Samoan
San Marinese
Sao Tomean
Saudi
Scottish
Senegalese
Serbian
Seychellois
Sierra Leonean
Singaporean
Slovakian
Slovenian
Solomon Islander
Somali
South African
South Korean
Spanish
Sri Lankan
Sudanese
Surinamer
Swazi
Swedish
Swiss
Syrian
Taiwanese
Tajik
Tanzanian
Thai
Togolese
Tongan
Trinidadian or Tobagonian
Tunisian
Turkish
Tuvaluan
Ugandan
Ukrainian
Uruguayan
Uzbekistani
Venezuelan
Vietnamese
Welsh
Welsh
Yemenite
Zambian
Zimbabwean
Note: Your can click on the field and start typing to find your citizenship faster.
How long have you been living in Ireland?
*
Less than 5 years
5-9 years
10 years or over
Unfortunately we won’t be able to assist you on this occasion.
PLEASE NOTE - You can only proceed with the application if you meet our minimum requirements.
Salesperson
Full name of Salesperson (if known, optional)
Equipment type?
*
Computer/Technology
Electrical/Appliances
Furniture
Other
Amount
*
Please enter a value greater than or equal to
299
.
Please Note: Only numbers allowed in this field
Term length
*
12
24
36
Which Flexirent term length would suit you best? You can check what your monthly payments may be using
Flexirent Calculator
.
First Name
*
Middle Name
Last Name
*
Changed name in the last 5 years?
*
Yes
No
Please enter full previous name
*
Your Date of Birth
*
Title
*
Mr
Mrs
Ms
Your Gender
*
Male
Female
Marital Status
*
De Facto
Divorced/Separated
Married
Single
Widowed
Your Address Details
Street address
*
Town
*
County
*
Eircode
Length of stay at current address?
*
Less than 3 years
3 years or longer
How long at the above address?
*
In years and months
Please provide previous address(es) for last 3 years
*
Previous address
Length of stay at this address
Note: Add more rows as necessary.
Note: We require 3 years address history to process the application.
How long?
*
In years and months
Your Mobile Phone
*
PLEASE NOTE:
Member of the Flexirent team will contact you on the number provided here to verify your details.
Your Home Phone
*
Your Work Phone
*
Your Email
*
Any recent credit problems within the past 5 years?
*
Yes
No
e.g. bankruptcy, defaults, difficulty making repayments etc.
In what way?
*
Declared Bankrupt
Default listed on credit report
Trouble making loan/CC repayments
Other
Please provide details
*
Your Income source
*
Full time employment
Part time employment
Business Owner / Sole trader
Business Owner / Partnership
Company Director
Casually employed
Other
Name of Employer
*
Job Title
*
Gross Salary (before tax)
*
Frequency
*
Weekly
Bi-Weekly
Monthly
Annually
Note: Please choose frequency of the amount that you have provided above.
Length of current employment
*
Less than 3 years
3 years or more
How long?
*
In years and months
Is this your first job?
*
Yes
No
Please provide your employment history within last 3 years.
Add more as necessary
*
Employer Name
Employment Type
Time in employment
Employment type examples:
Full time, Part time, Casual employment. If other, then please specify.
Time in employment example: 2 years, 6 months
(please always specify years and months)
Other partners name
*
Business trading Name
*
Business Activity
*
Length of directorship/ownership/length of time in industry
*
In years and months
Annual trading figures
*
Turn over
Net profit
Current Employment situation
*
Benefit
Home duties
Retired
Self employed
Superannuant
Student
Unemployed
Type of Benefit
*
Back to Education Allowance
Carers Benefit
Death Benefit
Invalidity Pension
Jobseekers Benefit
Other
State Pension (Age Pension)
Gross Income
*
Enter amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Time in current situation
*
In years and months
Do you have additional income i.e. rental income, benefits, other employment, pension etc.?
*
Yes
No
Please tick as it applies to you.
Other employment income
Yes
Details
*
Amount
Frequency
Enter amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Benefits
Yes
Please tick as it applies to you.
Back to Education Allowance
Yes
Details
*
Amount
Frequency
Enter amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Carers Benefit
Yes
Details
*
Amount
Frequency
Enter amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Death Benefit
Yes
Details
*
Amount
Frequency
Enter amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Invalidity Pension
Yes
Details
*
Amount
Frequency
Enter amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Jobseekers Benefit
Yes
Details
*
Amount
Frequency
Enter amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
State Pension (Age Pension)
Yes
Details
*
Amount
Frequency
Enter amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Other Benefits
Yes
Please Specify
*
Benefit Type
Amount
Frequency
Enter Benefit Type, amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Note: Add more rows as necessary.
Director’s salary
Yes
Details
*
Amount
Frequency
Enter amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Pension
Yes
Details
*
Amount
Frequency
Enter amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Other income
Yes
Such as rental income, dividends etc.
Details
*
Income Type
Amount
Frequency
Enter Other Income type, amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Financial dependents
*
Enter the number of dependants. Type in "0" (zero) if none.
Financial dependents (excluding spouse)
*
Enter the number of dependants excluding spouse. Type in "0" (zero) if none.
Is spouse a financial dependent?
*
Yes
No
Is spouse receiving income?
*
Yes
No
Your Spouse gross salary (before tax)
*
Enter amount (before tax) and frequency (weekly, bi-weekly, monthly, annually)
Residential status
*
Property Owner
Renting
Boarding
Living with parents
Value of property
*
Mortgage owing?
*
Yes
No
Please provide details
*
Mortgage provider
Amount owed
Monthly repayment amount
Monthly payment amount
*
Other monthly expences or finance
*
Business Loan
Car Loan
Car Lease
Personal Loan
Line of Credit
Rent / Board
Other Debt
Mortgage Repayment
None
Please tick as appropriate
Business Loan details
*
Recipient
Monthly Repayment
Car Loan details
*
Recipient
Monthly Repayment
Car Lease details
*
Recipient
Monthly Repayment
Personal Loan details
*
Recipient
Monthly Repayment
Line of credit details
*
Recipient
Monthly Repayment
Rent / board details
*
Recipient
Monthly Repayment
Other debt details
*
Recipient
Monthly Repayment
Mortgage repayment details
*
Recipient
Monthly Repayment
Credit Cards
*
Yes
No
Cards details
*
Card Type
Issuer
Credit Limit
Outstanding Balance
Example: Visa - AIB - 2000 - 1500
Note - Please add a new row for each additional Credit Card owned.
Overdraft facility
*
Yes
No
Overdraft amount
*
Next of kin
*
Please enter full name
Next of kin Home Phone
*
Next of kin Mobile Phone
*
How did you hear about Flexirent?
In store
Online
On this site
Direct mail
Print advertising
Word of Mouth
I'm a current or previous customer
I consent to Flexirent giving to and seeking from credit reporting agencies, including the Irish Credit Bureau, and other credit providers named in reports from those agencies, information about my personal and commercial activities and credit worthiness.
*
Yes
I consent to Flexirent contacting my employer; for the purpose of obtaining information in support of my application for credit, and/ or the management of my account.
*
Yes
I consent to Flexirent Privacy Policy.
*
Yes
Please read Flexirent Privacy Policy at
https://www.flexirent.ie/privacy-policy/
If we need to contact you in relation to your application, what is the best time to call?
Preferred contact date?
*
Preferred contact time?
*
09:15 – 11:15
11:15 – 13:15
14:15 – 16:15
16:15 – 17:45
Upload Your Documents
Unacceptable Documents Note
Please make sure the documents you upload are
not
:
- Blurred, Blacked out or unreadable
- Tampered with i.e. marked out or white out
- Folded or photo of a partial document
- Bank statements of less than 30 days
- Screenshots of Online bank statement without your name shown
- Hand written documents i.e. payslips
Please note that any Doctored or Tampered document may result in your application decision being delayed or declined.
Max file size for each of the uploads is 10MB.
Proof of ID
*
Drop files here or
Accepted file types: jpg, png, pdf.
Accepted Proof of ID documents:
- Irish citizens: Passport, Full Driving Licence, Garda Age Card, EU Travel Card
- Non Irish Citizens: Passport or EU Travel Card
Note: You can upload up to 2 files in this field
Proof of Address
*
Drop files here or
Accepted file types: jpg, png, pdf.
Accepted Proof of Address documents:
- Bank/Credit Card Statement, Utility Bill, Correspondence from Government bodies
Note: All documents must be within the last 3 months
Note: You can upload up to 2 files in this field
Proof of Income
*
Drop files here or
Accepted file types: jpg, png, pdf.
Please provide Bank statement from within last 90 days.
Note: Bank Statement must show a full months activity.
Note: You can upload up to 3 files in this field.
I confirm that all of the attached documents meet the requirements stated on this page.
*
Yes
Phone
This field is for validation purposes and should be left unchanged.
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