Businesss Finance Application

Application Details
What sort of vehicle are you looking to purchase?*
Which new dealer would you like to apply with?*
Which used dealer would you like to apply with?*
Which of these finance companies have you used previously?*
- United Dominions Corporation (UDC)
- European Financial Services Limited (EFS & EAF)
- Heartland Bank
- Branded Financial Services
- Nissan Financial Services
- None of these

Guarantor Details
Title*
Full name*
First Middle Last
Date of birth*

Day
Month
Year
Gender*
Relationship status*
Number of dependents*
Dependent ages
Drivers licence type*
Drivers licence number*
Drivers licence version*
Drivers licence expiry date*

Day
Month
Year
Country of birth*
Country of citizenship*
New Zealand resident*
Business phone number
Home phone number
Mobile phone number*
Email address*
Physical address*
Street Address City ZIP / Postal Code Country
Time at current address*
Residential type*
Postal address (if different)
Street Address Address Line 2 City ZIP / Postal Code Country
Previous address (if less than 3 years at current address)
Street Address Address Line 2 City ZIP / Postal Code Country
Time at previous address
Residential type
Personal Income*
Payment Occurrence*
- Weekly
- Fortnightly
- Monthly

Reference Details
Name*
First Last
Relationship*
Phone number*
Address*
Street Address Address Line 2 City ZIP / Postal Code Country
Residential type*

Business Details
If different to applying business
Current Employer
Business Name*
Business Industry*
Business registration number*
Date of business registration*

Day
Month
Year
Business GST number
Contact person*
Business phone*
Business email*
Business Website*
Business street address*
Street Address Address Line 2 City ZIP / Postal Code Country
Previous Employer
Previous employer (if less than 1 year in business)
Occupation
Employment type
Time at previous employer
Previous employer phone number
Previous employer address
Street Address Address Line 2 City ZIP / Postal Code Country

Terms of Agreement
I/we understand and authorise that: The information received from me/us will be securely held by the Dealer. I/we may access and correct this information under the Privacy Act 1993. The information may be used by the Dealer to:
- consider my/our application for facilities, products or services or any future applications for facilities, products or services;
- administer, manage and monitor any facilities, products or services provided to me/us;
- obtain information about my driver licence from Driver Check, a secure internet site set up by the NZ Transport Agency, such as licence classes and endorsements held, any licence conditions, and licence status;
- conduct market research, data processing and statistical analysis;
- unless I/we disagree, provide me/us with information about other facilities, products or services including selected third party products or services.
The Dealer may disclose information about me/us to its related companies (as defined by the Companies Act 1993), agents or contractors for the above purposes.

The Dealer may disclose information about me/us to credit reference agencies for the purpose of obtaining a credit report on me/us. Those credit reference agencies may retain that information and provide it to their customers who use their credit reporting services.

If I/we default in any obligations to the Dealer then information about me/us may be disclosed to credit reference or debt recovery agencies and retained by them. Those agencies may provide that information to their customers who use their credit reporting services.

The Dealer may each obtain information and make such enquiries about me/us as each of them considers is warranted from any source including from its related companies (as defined by the Companies Act 1993) and credit reference agencies for the above purposes.

The Customer and each Guarantor consents to the Creditor obtaining information about their drivers licences from Driver Check, a secure interest site set up by the NZ Transport Agency, such as licence class and endorsements held, any licence conditions, and licence status.

I/we warrant that the information provided is true and correct and I/we acknowledge it will be relied upon by the finance companies to determine whether or not to accept my/our application for finance. I/we understand that The Ebbett dealerships are not finance institutions and that they are only assisting me in getting the finance option best suite to me/us.
Consent*
I agree to these terms of agreement.
Your name*
First Last
Phone number*
Email*
Your signature*

Step 1 of 6

Application Details

Guarantor Details

Purchaser Details

Financial Accounts

Liabilities

Assets

General Financial Notes

Reference Details

Business Details

Current Employer

Previous Employer

Terms of Agreement