Alternate Finance Loan Application Form

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

Contact Details:
Title:
Surname:  *
First Names:  *
D.O.B / /
 Phone:  *
Cellphone:
Email:  *
License No:       Expiry /
License Version No: (Sec. 5b on license)
Passport No:       Expiry /
Marital Status:  *
Current Occupation:  *
Current Employer:  *
Phone:  *
How Long In Current Job:  *
Previous Occupation:  *
Previous Employer:  *
Phone:  *
How Long In Previous Job:  *
 
Partner Details:
Title:
Surname:
First Names:
D.O.B / /
 Phone:
Cellphone:
Email:
Current Occupation:
Current Employer:
Phone:
How Long In Current Job:
 
Address Details:
Street:  *
Suburb:
City:  *
How Long:
Living Situation:
 
Monetary Details:
Credit References: (If any)
 
Amount Required:  *
Purpose of Loan:  *
Repayments (approx): $  *
   *
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?

Security Details:

* 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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Contact Details

50 Sandyford Street
Sydenham
Christchurch

Ph: (03) 379 7798
Karen
Abbey

Contact Karen or Abbey to talk about your options.