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Full Finance Application

Car Information

Stock Number:

Make / Model:

Year:

Vin:

Price:

Applicant Information

Applicant First Name:

Applicant Last Name:

Applicant Date of Birth:

Driver's Licence Number 5A:

Driver's Licence Number 5B:

Marital Status:

Number of Dependants:

2nd Applicant Information

Applicant Address Information

Address:

Years at address:

Tenancy:

Previous Address:

Years at Previous Address:

Email:

Private Phone:

Business Phone:

Mobile Phone:

Employer Information

Present Employer:

Years:

Address:

Occupation:

Previous Employer:

Years:

2nd Applicant Employer:

2nd Applicant Years:

2nd Applicant Address:

2nd Applicant Occupation:

Parents / Relative Information

Parents Name/Nearest Relative:

Address:

Relationship:

Finance Information

Finance Reference 1:

Finance Reference 2:

Bankers:

Account Number:

Approximate Amount Requird:

ASSETS	(please note all assets which are jointly owned)	Joint	LIABILITIES
HOME			MORTGAGES
FURNISHINGS			HP ACCOUNTS
BANK
CAR			OTHER LOANS
INVESTMENTS
OTHER			TOTAL

TOTAL			NET WORTH

INCOME (monthly)			EXPENSES (monthly)
AVERAGE TAKE HOME PAY			MORTGAGES/RENT PAYMENTS
2nd APPLICANT 'S TAKE HOME PAY			HP AND CREDIT ACCOUNTS
OTHER INCOME			OTHER EXPENSES
DESCRIPTION

TOTAL			TOTAL

Information Statement/Authorisation Pursuant To The Privacy Act 1993
Please read this statement/authorisation notice in full.

Have you ever had or are there now any attachments or legal proceeding against you, or any action for payment default?

Yes No

If yes, please state details:

I apply for a loan and certify that the particulars above and overleaf are true and correct and that I am over the age of 18 years and am not an undischarged bankrupt. Pursuant to the Privacy Act 1993 I authorise any finance company to contact any credit reporting agencies, credit providers, my employer(s), accountant(s), or any other source, to obtain, check and exchange (both now and in the future) such personal, financial and commercial information and references about me/us as is necessary for the purposes of considering this application, the protection and administration of any loan arising out of this application, and to assist in the enforcement of any agreement between me/us and any finance company. I agree that you may produce this authority to such parties for the purposes of collecting such information. Under the provisions of the Privacy Act 1993, you are entitled to have access and request correction to personal information held about you.

I have read and accept the terms and conditions within this informative statement/authorisation.

I Accept Terms And Conditions

Please ensure the details you have provided above are correct before submitting the application.

CUSTOMER PRIVACY CLAUSES

I/We understand and authorise that:
The information received from me/us will be securyly held by the relevant financeier("Financier"). I/we may access and correct this information under the Privacy Act 1993.
The information may be used by the Financier to:

consider my/our application for facilities,products or service or any future applicantions for facilities, products or services;
administer, manage and monitor any facilities, products or services provided to me/us;
conduct market research, data processing and statistical analysis; and
unless I/we disagree, provide me/us with information about other facilities, products or services including selected third party produts or services.

The Financier may disclose information about me/us to its related companies(as defined by the Companies Act 1993), agents or contractors for above purpose.

The Financier may disclose information about me/us to credit reference agencies for the purpose of obtaining a credit report on me/us. Those credit reference agencies may retain that information and provide it to their customer who use their credit reporting services.

If I/we default in any obligations to the financier then information about me/us may be disclosed to credit reference or debt recovery agencies and retained by them. Those agencies may provide that information to their customer who use their credit reporting services.

The financier may obtain information and make such enquiries about me/us as that Financier considers warranted from any source including from its related companies( as defined by the Companies Act 1993) and credit refernece agencies fro the above purpose.

Security Code:

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