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Personal Details
  •   Title
  •   First Name
  • Middle Name
  •   Surname
  •   Date of Birth
  •   Gender
  •   Marital Status
  •   No of Dependents
  • Dependents Age(s)
Driver Licence Details
  •   Licence Type
  •   Licence Number
  •   Licence Version No
  •   Driver Licence Expiry Date
Citizenship Details
  •   New Zealand Resident
  •   Country of Birth
  •   Country of Citizenship 1
  • Country of Citizenship 2
  • Country of Citizenship 3
Phone And Email Details
  • Business Phone Number
  • Home Phone Number
  •   Mobile Phone Number
  • Fax Number
  • Email
Enter Physical Address
  • Attention
  • Building Name
  • Unit/Floor Type
  • Unit/Lot
  •   Street No
  •   Street Name
  •   Street Type
  •   Suburb
  •   City
  • Postcode
  • Country
  • Time at Address
  • Years     Months    
Enter Previous Physical Address
  • Attention
  • Building Name
  • Unit/Floor Type
  • Unit/Lot
  •   Street No
  •   Street Name
  •   Street Type
  •   Suburb
  •   City
  • Postcode
  • Country
  • Time at Address
  • Years     Months    
Current Employment
  •   Employer Name
  •   Occupation
  •   Employment Type
  • Employer Phone Number
  • Employer Fax Number
  •   Employer Address
  •  
  •  
  •  
  • Time With This Employer
  • Years     Months    
Previous Employment
  •   Employer Name
  •   Occupation
  •   Employment Type
  • Employer Phone Number
  • Employer Fax Number
  •   Employer Address
  •  
  •  
  •  
  • Time With This Employer
  • Years     Months    
Nearest Relative(not living with you)
  •   Name of Relative
  •   Relationship to Customer
  •   Phone Number
  •   Relative Address
  •  
  •  
  •  
Credit Reference
  • Credit Reference Name/Detail
Vehicle Details
  • Stock#
  • Make
  • Model
  • Year
Tradein Vehicle Details
  • Make
  • Model
  • Year
  • Mileage
  • Reg#
Assets
  • Home Value($)
  • Vehicle Value($)
  •   Furniture and Effects Value($)
Liabilities
  •  
  • Mortage/Rent
  • Loans
  • Credit Cards
  • Personal Loan/ H.P
  • Balance Owing($)
  • Monthly Payment($)
  • Lender
Income
  •  
  • Take Home Pay (After Tax)
  • Partner Take Home Pay (After Tax)
  • Amount($)
  • Frequency
  • Additional Details

  • We authorise Wholesale Cars Direct and UDC Finance Ltd, Marac, NZ Credit Union its related companies, agents, assigns, associates, transferees, to collect, check and exchange such personal, information about me/ us to determine whether to open a credit account in our name. I/ We apply for the above loan and certify that the particulars above are true and correct. I/ We authorise Wholesale Cars Direct and UDC Finance Ltd, Marac, NZ Credit Union, to contact any credit reporting agencies, credit providers, my/ our employers, accountants, or any other source, to obtain, check and exchange such personal financial and commercial information and references as it necessary for the purpose of considering this application, the protection and administration of any loan arising out of this application and to assist the enforcement of any agreement between me/ us and any finance company. I/ We agree that you may reproduce this authority to such parties for the purpose of collecting information. Under the provisions of the Privacy Act 1993, you are entitled to have access and request correction to personal information about yourself.

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