Crester Credit Loan Application Form

* Finance is available to residents of the South Island only.

Contact Details:
Title:	Select Mr Ms Mrs Miss Dr
Surname:	*
First Names:	*
D.O.B	Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / Year 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Phone:	*
Cellphone:
Email:	*
License No:	Expiry 01 02 03 04 05 06 07 08 09 10 11 12 / 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
License Version No:	(Sec. 5b on license)
Passport No:	Expiry 01 02 03 04 05 06 07 08 09 10 11 12 / 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
Marital Status:	Select Marital Status Single Married Defacto Seperated Divorced  *
Current Occupation:	*
Current Employer:	*
Phone:	*
How Long In Current Job:	Select ±1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years +10 years  *
Previous Occupation:	*
Previous Employer:	*
Phone:	*
How Long In Previous Job:	Select ±1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years +10 years  *
Partner Details:
Title:	Select Mr Ms Mrs Dr
Surname:
First Names:
D.O.B	Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / Year 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Phone:
Cellphone:
Email:
Current Occupation:
Current Employer:
Phone:
How Long In Current Job:	Select ±1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years +10 years
Address Details:
Street:	*
Suburb:
City:	*
How Long:	Select ±1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years +10 years
Living Situation:	Select Below.. Own Rent Board
Monetary Details:
Bank:	*
Branch:	*
Account Number:	- -  *
Credit References: (If any)
Amount Required:	*
Purpose of Loan:	*
Repayments (approx): $	*
	Select weekly fortnightly monthly  *
Relative / Guarantor:	*
Security Details:

Security Items:	House / Property:     Furniture / Appliances:     Other: Specify Other: Car Make:     Model:     Year:     Plate:     Insured?     Insurer:     Money owing?     Money owing to?
* You must select at least one of the security items below to put against your loan.
I/We warrant that the information given above is true and correct and hereby AUTHORISE this lender making all enquiries and obtaining all information it Shall deem necessary at its discretion. I/We AUTHORISE all companies, institutions, credit agencies, organizations and other persons approached by This company for information about me/us to provide the information requested. i/We acknowledge that this company shall not be required to comply with The provisions of Principle 3 of the Privacy Act 1993 as to whether I/We shall be aware of : * The fact that the information is being collected * the purpose for which the information is being collected * the intended recipients of the information * the consequences for providing information * the rights of access to and correction of such information * or that the collection of the information is authorized or required by or under law   Accept Terms & Conditions
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