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Home
The Team
Dealers
Finance Calculator
Contact Us
Apply Now
Full Application
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Full Application
Full Application
createdesignstudio
2021-02-26T08:03:45+13:00
Step
1
of
6
- Applicant Info
16%
Is this a joint application?
Yes
Applicant Details
First Name
*
Last Name
*
Date of Birth
*
DD slash MM slash YYYY
Marital Status
*
Single
Married
De Facto
Number of Dependants
*
Drivers License Number
*
Version Number
*
Residency Status
*
NZ Citizen
Permanent Resident
Student Visa
Work Visa
Other
If "Other" please specify
Date Visa Issued
DD slash MM slash YYYY
Home Phone
Mobile Phone
Work Phone
Email
*
Partner Details
First Name
*
Last Name
*
Date of Birth
*
DD slash MM slash YYYY
Drivers License Number
*
Version Number
*
Address Details
I currently:
*
Own House
Rent
Board
Current Address
*
Suburb
*
City
*
Years lived at current address?
*
Previous Address
*
Suburb
*
City
*
Years lived at previous address?
*
Employment Details
Current Employer
*
Occupation
*
Address
*
Years worked here
*
Previous Employer
*
Occupation
*
Address
*
Years worked here
*
Partner's Employer
*
Occupation
*
Address
*
Years worked here
*
Emergency Contacts
Parents Name
*
Relationship
*
Address
*
Phone Number
*
Account References
e.g. Hire Purchase, Credit Card etc..
Reference 1
Reference 2
Your Bank
Account Number
Monthly Income
Applicant average take home pay
*
Other income
Spouse's average take home pay
*
Spouse's other income
Total Monthly Income
*
Assets
Home ( Joint / JFH )
Furnishings
Bank
Car
Investments
Other
Total Assets
*
Monthly Expenses
Mortgages / Rent Payments
HP / Credit Accounts
Rates / Phone / Power / Insurance
Life Insurance / Building Society
Car / Other Expenses
Total Monthly Expenses
*
Liabilities
Mortgages
HP / Credit Accounts
Bank Overdraft
Other creditors / loans
Total Liabilities
*
Net Worth
*
Loan Details
I am wanting to finance:
*
Car
Motorcycle
Boat
Caravan
Personal Loan
Purchase Price
*
Deposit
*
Finance Amount
*
Preferred Term
*
6 Months
12 Months
18 Months
24 Months
36 Months
48 Months
60 Months
Frequency
*
Weekly
Fortnightly
Monthly
Quarterly
Yearly
Legal Stuff
Privacy Act
Information about each person named in this form (Relevant Person) may be collected and held by Heartland Bank Limited, its trading division MARAC, its related entities, successors, assigns, agents and associates (Heartland). That information may be used by Heartland to consider this application for products or services (and any future application involving the Relevant Person). If the information is not provided, Heartland may not be able to provide the requested products or services. The information may also be used by Heartland to develop and run its business, including administering and monitoring products or services provided to the Relevant Person (or any related entity), compliance with legal and regulatory requirements (including identity verification requirements) and providing the Relevant Person with information about other products or services, including those of selected third parties.For the above purposes, the Relevant Person acknowledges that Heartland may provide and obtain information about the Relevant Person to or from other organisations or people Heartland considers appropriate, including its service providers, other financial and insurance institutions, government departments, the Relevant Person’s employer/accountant, and other appropriate persons. Heartland may use the services of credit reporting agencies on an ongoing basis for purposes relating to the provision of credit to the Relevant Person (or any related entity), and may exchange information about the Relevant Person with those agencies, including default information. Those agencies may retain that information and provide that information to other customers who use their credit reporting services. Each Relevant Person may request the full details of every organisation or person to whom Heartland has disclosed information about the Relevant Person. Individuals have rights to access and request correction of their personal information under the Privacy Act 1993.
Acceptance
I/We certify as or on behalf of the Applicant that the information in this form is true and correct.
I/We acknowledge that if I/We do not provide all or any part of the information requested on this application form, my/our application for finance may be declined.
I/We declare that I/We have read and understood the provisions contained in this Application.
By submitting your application to Go Finance Ltd, you are inviting and inviting Go Finance Ltd (and nominated third parties) to contact you (including by phone and email) in relation to discussing and finalising finance, GAP and LPI insurance, extended warranty products and other products which may be of interest to you.
To submit your application please type ACCEPT in capital letters below:
*
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