Yard: $9990 4WD EUROPEAN SPORTSCARS $6990 HOLDEN / FORD
Make:      Model:
1
Applicant Info
Your Name:
(SURNAME)
(FIRST NAMES)
Marital Status: Number of Dependants:
Spouse's Name:
(SURNAME)
(FIRST NAMES)
Date of Birth:
(APPLICANT)
(SPOUSE)

Driver's Licence No (5a):
(APPLICANT)
(SPOUSE)

Driver's Licence Version (5b):
(APPLICANT)
(SPOUSE)
2
Contact Details
Current Address:
Years At Address:
Tenancy:
Other (Detail):
Previous Address:
Years At Address:
Email Address:
Phone: (PRIVATE)     (BUSINESS)    (MOBILE)
3
Employment Details
Present Employer: Years:
Address: Occupation:
Previous Employer: Years:
Spouse's Employer: Years:
Address: Occupation:
4
Referees
Parents Name/Nearest Relative:
Address:
Relationship:
Account References: (1)
(2)
Bankers: Account No:
5
Trade-In Vehicle Details
Make
Model
Year
Mileage
Reg#
6
Finance Required
Approximate Loan Amount: $
7
Accounting Details
ASSETS (please note all assets which are jointly owned) joint LIABILITIES
Home $ Mortgages $
Furnishings $ HP/Credit Accounts $
Bank $ Bank O/D $
Car $ Other Creditors, Loans $
Investments $
Other $ TOTAL $
TOTAL $ NET WORTH $
INCOME (monthly) EXPENSES (monthly)
Average Take Home Pay $ Mortgage/Rent Payments $
Spouses Take Home Pay $ HPand Credit Accounts $
OTHER INCOME $ Rates, Phone, Power, Insurance $
Life Insurance, Building Society $
TOTAL $ Car and other Expenses $
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:

Where the applicant is a limited liability company, this authority and acknowledgement applies to all directors of that company.
I/We understand that I am/we are not required to provide any personal information to the dealer/broker named in this application for finance (application), but that failure to do so may prejudice my/our chances of obtaining finance.
I/We certify that the information in this application is true and correct, and that I am/we are over the age of 18 years and I am/we are not an undischarged bankrupt(s).
I am/We are aware that the information in this application is collected initially for the purpose of considering my/our application for finance, and may be given to a number of lender's at the discretion of the dealer/broker. If this application is approved, I/we understand that the information will be used by the lender for the purpose of administering the loan. I/We agree that the lender may send me/us details of other products and services from time to time and may use all personal information held about me/us for the purpose of considering any future application for finance made by me/us and/or offering me/us further financial accomodation.

By completing this application I/We authorise the dealer/broker and/or lender;

- to collect from credit reporting agencies, credit providers, my/our employer(s), accountant(s) or other named persons, such personal, financial and commercial information and references about me/us as is necessary for the purpose of considering this application, and for those third parties to disclose information to the dealer/broker/and or lender;

- to disclose personal information about me/us to credit reporting and debt collection agencies in the event of any default in any sum owing to the lender, and also to any third party making an authorised enquiry about me/us.

I/We understand that, pursuant to the Privacy Act 1993, I/we have the right to request access to and correction of any personal information held by the dealer/broker.

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.