Vehicle Quote Request

NB: To enter into a novated lease, your employer must have an existing relationship with SMB.
If you are unsure whether your employer has an existing relationship with SMB, please contact your HR department.

Please complete and submit the form below to have your Vehicle Quote Request emailed directly to SMB.

Previous Contact
Have you spoken to or received a quote from an Account Manager previously?
If so who?

Personal Details
Name:		Date of Birth (For insurance quotation):
City:		State:
Postcode (home):		Contact Phone:
Contact Email:		Contact Fax:

Employment Details
Employer:		Division:
Location:
Gross Annual Salary:		Vehicle Allowance (if applicable):

Type of Vehicle
	Is This a New Vehicle?
	Is This a Used or Demo Vehicle?
	Are you an Existing SMB Client?
	Is This a Release of an Existing Vehicle?
	Is this a Second Novated Vehicle?

Vehicle Details

Make:

Transmission:

Model:

Air Conditioning:

Yes

Type:

Alarm:

Yes

Year:

Tint:

Yes

Engine Size:

CD Player:

Yes

Preferred Colour:

Other Options:

Anticipated Annual Kilometres:

Do You Have a Company Fuel Card?:

Yes No

Percent Business Use (If applicable):

Used Vehicle Value:

Used Vehicle Supplier:

Supplier Type:

Dealership Private Sale Other

Other:

Trade In Details

Rego:

Transmission:

Make and Model:

Air Conditioning:

Yes

Year:

Alarm:

Yes

Current Kilometres:

Owned Outright?:

Yes

Approximate Value:

Under Finance?:

YES

Finance Company:

Lease Term: (Please tick preferred option)
	12 Months	24 Months	36 Months
	48 Months	60 Months

Notes to SMB: