PPSR Registration Details

Registration Type: [ ] Commercial / [ ] Consumer / [ ] Transitional

Grantor Details

Grantor Type: [ ] Individual / [ ] Company / [ ] Other (e.g. Trustee)

If Grantor is an Individual

• Family Name: [Family Name]
• Given Name(s): [Given Names]
• Date of Birth: [DD/MM/YYYY]
• Address: [Street Address, Suburb, State, Postcode]
• Driver's Licence Number (Optional): [Number]

If Grantor is a Company

• Organisation Name: [Full Legal Company Name]
• ACN / ARBN: [ACN or ARBN Number]
• Registered Address: [Address from ASIC register]

If Grantor is a Trust

• Trustee Name: [Legal Name of Trustee Company or Individual]
• ACN of Trustee (if company): [ACN Number]
• ABN of Trustee (if individual): [ABN Number]

Secured Party Details

• Organisation Name: [Your Business Legal Name]
• ACN / ABN: [Your ACN or ABN]
• Contact Email: [Email Address]
• Contact Phone: [Phone Number]
• Address for Service: [Business Address]

Collateral Details

Collateral Type: [ ] Specific Serial Numbered / [ ] All Present and After-Acquired

If Specific Serial Numbered

• Type of Goods: [e.g. Motor Vehicle, Excavator]
• Serial Number: [VIN, Chassis, or Manufacturer Number]
• Description: [Brief description including Make, Model, Year]

If General (All Assets)

• Description: All present and after-acquired property of the Grantor, including but not limited to [e.g. inventory, equipment, receivables, motor vehicles].

Registration Terms

• Registration Start Date: [DD/MM/YYYY]
• Duration: [ ] Indefinite / [ ] 7 Years / [ ] [Number] Years
• Security Agreement Reference: [Invoice Number or Contract Number]
• Date of Security Agreement: [DD/MM/YYYY]

Declaration

I declare that I have a valid security interest over the collateral described above and that the details provided are true and correct.

Authorised Signatory Name: [Full Name] Date: [DD/MM/YYYY]