1. Your personal details:
|
Surname:
|
First Name:
|
Email address:
|
Date of birth:
of ,
|
Do you have a New Zealand Residency?
|
Home phone:
|
Work phone:
|
Cell phone:
|
Home address:
|
Current tenancy:
|
How long have you lived there?
|
Previous address:
|
Previous tenancy:
|
How many years did you live there?
|
Marital status:
|
Number of dependants:
|
Drivers licence number:
|
Type of licence:
|
2.Employment Details:
|
Present employer:
|
How long with present employer?
|
Present wages or salary:
|
Present employers address:
|
Present employers phone:
|
Present employer contact person:
|
Previous employer:
|
How long with previous employer?
|
Previous wages or salary:
|
Previous employers address:
|
Previous employers phone:
|
Previous employer contact person:
|
3. References:
|
Nearest relative (not living with you):
|
Nearest relative phone:
|
Nearest relative address:
|
Nearest relative relationship:
|
Personal contact:
|
Personal contact phone:
|
Personal contact address:
|
4. Account References:
|
(Please list all previous or existing loans, credit cards etc):
|
Previous finance co:
|
Are these accounts still current?
|
If yes; please specify:
|
5. How did you hear of Oxford Finance:
|
How did you hear of Oxford Finance:
|
6. Purchase Details:
|
Purchase price:
|
Other costs:
|
Total cost:
|
Purpose:
|
Applicants contribution:
|
Trade in:
|
This loan amount:
|
Total funding:
|
Term of loan:
|
7. Trade in Details:
|
Are you going to trade in your old vehicle as part of this purchase?
|
Year of manufacture:
|
Make:
|
Model:
|
Registration expiry:
|
Value of trade:
|
Net trade in value:
|
Is an insurance settlement on a previous vehicle part of this purchase?
|
Insurance company:
|
Amount of settlement:
|
Settlement made out to:
|
8. Finance Details:
|
Average Monthly Expenditure For fields that don't apply put a 'zero' :
|
Rent/mortgages:
|
Car loan expenditure:
|
H.P:
|
Other loan expenditure:
|
This loan expenditure:
|
Total expenditure:
|
Assets For fields that don't apply put a 'zero' :
|
House:
|
Furnishings:
|
Investments/bank:
|
Car:
|
Other assets:
|
Total assets:
|
Average Monthly Net Income:
|
Applicant:
|
Other/source:
|
Total income:
|
Liabilities For fields that don't apply put a 'zero' :
|
Mortgage outstanding:
|
Store cards:
|
Credit cards:
|
Car loan liabilities:
|
Bank loan/overdraft:
|
Other liabilities:
|
Total liabilities:
|
Bank account details (for this loan):
|
Bank:
|
Branch:
|
A/C number:
|
9. Co-Borrower:
|
Are you applying for this loan with a co-borrower?
|
Your co-borrower's name:
|
10. Privacy Act:
|
Have you ever had or are there now any attachments or legal proceeding against you, or any action for payment default?
|
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 (of applicant):
|
To help prevent spam, please enter the word "area" here:
|
|
|