Online Personal loan application

1. Primary Borrower:
Your primary borrower's name:	Primary borrower's Email:
2. Co-Borrower:
Surname:	First name:	Date of Birth:	Are you applying for this loan with a co borrower? Yes No
Do you have a New Zealand Residency?	Home Phone:	Work Phone:	Cell Phone:
Home Address:	Tenancy:	How many years have you lived there?
Occupation:	Email Address:
Relationship:	Number of Dependants:
Drivers Licence:	Type of Licence:
3. Employment Details:
Present employer:	How long?	Wages or Salary:
Address:	Phone:	Contact person:
Previous Employer:	Phone:	Contact Person:
4. Finance Details:
Average Monthly Net Income:
Co-Borrower:	Other/Source:	Total Income:
5. Privacy Act:
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 state details:
I/We certify that the particulars above are true and correct and that I am over the ago of 18 years and am not an undischarged bankrupt. Pursuant to the Privacy Act 1993 I/We authorize Oxford Finance to contact any credit reporting agencies, credit providers, my/our 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 purpose of considering this application, or for any future application, the protection or administration of any loan rising out of this application and to assist in the enforcement of any agreement between me/us and any finance company. I/We 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 consideration to personal information held against you.
Date:	Full Name:
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