Finance Application

General

Applicants First Name*

Applicants Last Name*

Date of Birth*

Applicant Company Name (if commercial application)

Contact Details

Phone Number*

Mobile Number*

Email Address*

Vehicle Details

Vehicle Interested In*

Personal Details

Country of Citezenship*

Country of Birth*

Address Details

Current Address*

Current Suburb*

Current City*

Time at Current Address

Time at Previous Address

Previous Address*

Previous City*

License Details

License Number (5a)*

License Version (5b)*

License Expiry*

Employer & Income

Employer Details

Occupation*

Time in current Role*

Current Employer*

Current Employer Address*

Employer Phone Number*

Previous Employer*

Time in Previous Role*

Income

Average Net Monthly Income (after tax) ($)*

Spouse's Average Net Monthly Income (after tax) ($)

Other Income ($)

Source of other Income ($)

Financial Position

Assets Value

Please show the combined totals if more than one applicant

Property ($)*

Furnishings ($)*

Bank Savings ($)*

Kiwisaver ($)*

Vehicle ($)*

Other Investments ($)*

Liabilities

Please show the combined totals if more than one applicant

Mortgages

Balance ($)*

Monthly Repayments ($)*

Credit Cards

Balance ($)*

Monthly Repayments ($)*

Personal Loans

Balance ($)*

Monthly Repayments ($)*

Vehicle Loans

Balance ($)*

Monthly Repayments ($)*

Other Hire/Purchases/Credit

Balance ($)*

Monthly Repayments ($)*

Rent Amount if not mortgaged (Weekly) ($)

Weekly Repayments ($)*

Mirage

ASX

Outlander

Outlander PHEV

Pajero Sport

Triton

Eclipse Cross

Eclipse Cross PHEV

Express Van

Contact Details

Vehicle Details

Address Details

License Details

Employer Details

Income

Assets Value

Liabilities