APPLICATION FOR CREDIT Loan purpose* Vehicle House purchase Other Vehicle make and year Vehicle model Purchase price Deposit House Address Purchase Price/Value Deposit/Equity Other Joint applicant Individual application Applicant’s first name Applicant’s Surname Applicant’s DOB Applicant’s Driver license Employment details Version Joint applicant’s first name Joint applicant’s Surname Joint applicant’s DOB Joint applicant’s Driver license Employment details Version Email Mobile Phone Number Home Phone Number Work Phone Number Fax Number Residency Status SelectNZ CitizenPermant ResidentStudent VisaWork VisaOther Date Issued Other (Please Indicate) Address and Tenancy SelectOwn HouseRentingBoardingFamily HouseOther Other (Please Indicate) Current Address Years at address Previous Address Years at address Current Employer Previous Occupation Address Years Spouse Employer Previous Occupation Address Years Spouse Previous Employer Previous Occupation Address Years Parent’s Name Relationship Address Phone Number Another contact Relationship Address Phone Number Account Reference 1 Account Reference 2 Bankers Account Number ASSETS ( Please note all assets which are jointly owned ) Home ( Joint / JFH ) Furnishings Bank Car Investments Other Home ( Joint / JFH ) Furnishings Bank Bank Car Investments Other Total $ INCOME ( Monthly ) Applicant average take home pay Spouse’s take home pay Other income Applicant average take home pay Other income Total $ LIABILITIES Mortgages HP / Credit accounts Bank O / D Other creditors / Loans Mortgages HP / Credit accounts Bank O / D Other creditors / Loans Total $ EXPENSES ( Monthly ) Mortgages / rent payments HP / Credit accounts Rates / phone / power / insurance Life insurance / building society Car / other expenses Mortgages / rent payments HP / Credit accounts Rates / phone / power / insurance Life insurance / building society Car / other expenses Total $
