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

Next Gen Outlander

Contact Details

Vehicle Details

Address Details

License Details

Employer Details

Income

Assets Value

Liabilities