Finance Application

More than One Applicant?:
Applicant First Name:*
Applicant Middle Name:
Applicant Last Name:*
Applicant Date of Birth:*
Country of Citizenship:*
Country of Birth:*
Relationship Status:*
No. of Dependants:*
Applicant Company Name (if Commercial Application):
Are you registered for GST?:
GST Registration Number:
Contact Details
Contact Phone:*
Mobile Phone:*
Email:*
Second Applicant Details
Applicant First Name:*
Applicant Middle Name:
Applicant Last Name:*
Applicant Date of Birth:*
Country of Citizenship:*
Country of Birth:*
Relationship Status:*
No. of Dependants:*
Applicant Company Name (if Commercial Application):
Are you registered for GST?:
GST Registration Number:
Contact Details
Contact Phone:*
Mobile Phone:*
Email:*
Preferred Contact Method

We may require further information for your application - what is the best way to contact you?

Contact Phone
Mobile Phone
Email
Licence Details
Applicant Licence Number (5a):*
Applicant Licence Version (5b):*
Applicant Licence Expiry Date:*
Applicant Licence Type:*
Second Applicant Licence Details
Applicant Licence Number (5a):*
Applicant Licence Version (5b):*
Applicant Licence Expiry Date:*
Applicant Licence Type:*
Vehicle Details
Vehicle Interested In:*
Vehicle Type:*
Vehicle Being Traded?*
Vehicle Age:*
Vehicle Make & Model:*
Vehicle Registration Number:*
Vehicle Kilometres:*
Vehicle Finance Owing?:*
Current Address:*
Current Suburb:*
Current City:*
Residential Status:*
Time At Current Address:*
Time At Previous Address:*
Previous Address:
Previous City:
Occupation:*
Time in Current Role:*
Current Employer:*
Current Employer Address:*
Contact Number for Employer:*
Second Applicant Employer Details
Occupation:*
Time in Current Role:*
Current Employer:*
Current Employer Address:*
Contact Number for Employer:*
Previous Employer:
Time in Previous Role:
Second Applicant Previous Employer Details
Previous Employer:
Time in Previous Role:
Assets Value (Please show the combined totals if more than one applicant)
Property ($):
Furnishings ($):
Bank Savings ($):
Kiwisaver ($):
Vehicle ($):
Other Investments ($):
Please State Other Investments:
Liabilities (Please show the combined totals if more than one applicant)
Mortgages
(Balance) ($) :
(Monthly Repayment) ($) :
Credit Cards
(Balance) ($) :
(Monthly Repayment) ($) :
Personal Loans
(Balance) ($) :
(Monthly Repayment) ($) :
Vehicle Loans
(Balance) ($) :
(Monthly Repayment) ($) :
Other Hire Purchases/Credit Accounts
(Balance) ($) :
(Monthly Repayment) ($) :
Rent Amount Per Week (if not mortgaged) ($):
Income (Monthly)
Average Net Monthly Income (after tax) ($):
Spouse's Average Net Monthly Income (after tax) ($):
Other Income ($):
Please State Other Income:
Other Information

Please provide us with any other information that will assist your application.

Please specify:
Terms and Conditions
I have read and accept the conditions:*
Yes