Consumer Finance Application

Step 1 of 7

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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)
- Nissan Financial Services
- Heartland Bank
- Branded Financial Services
- Nissan Financial Services
- None of these

Application Type*
Purchaser 1 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*

DD
MM
YYYY
Country of birth*
Country of citizenship*
Residency Status*
Work visa expiry date*
DD slash MM slash YYYY
Email address*
Mobile phone number*
Home phone number
Business phone number
Physical address*
Street Address City ZIP / Postal Code Country
Time at current address*
Residential type*
Postal address (if different)
Street Address City ZIP / Postal Code Country
Previous address (if less than 3 years at current address)
Street Address City ZIP / Postal Code Country
Time at previous address
Purchaser 2 Details
Title*
Full name*
First Middle Last
Date of birth*

Day
Month
Year
Gender*
Drivers licence type*
Drivers licence number*
Drivers licence version*
Drivers licence expiry date*

Day
Month
Year
Country of birth*
Country of citizenship*
Residency Status*
Work visa expiry date*
DD slash MM slash YYYY
Email address*
Mobile phone number*
Home phone number
Business phone number
Physical address*
Street Address City ZIP / Postal Code Country
Time at current address*
Purchaser 2 Residential type*

Purchaser 1 - Employer Details
Current Employer
Employer*
Employer phone number*
Occupation*
Employment type*
Time at employer years*
Time at employer months*
Employer address*
Street Address City ZIP / Postal Code Country
Purchaser 1 - Previous Employer
Previous employer (if less than 3 years at current)
Previous employer phone number
Occupation
Employment type
Time at previous employer years
Time at previous employer months
Previous employer address
Street Address City ZIP / Postal Code Country
Income
Income Type*
Take home pay*
Payment Occurence
- Weekly
- Fortnightly
- Monthly
Spouse/Partner Income Type*
Spouse/partner take home pay
Payment Occurence
- Weekly
- Fortnightly
- Monthly
Other income
Income Description
Payment Occurence
- Weekly
- Fortnightly
- Monthly
Purchaser 2 - Employer Details
Current Employer
Employer
Employer phone number
Occupation
Employment type
Time at employer years
Time at employer months
Employer phone number
Employer address
Street Address City ZIP / Postal Code Country
Purchaser 2 - Previous Employer
Previous employer (if less than 3 years at current)
Previous employer phone number
Occupation
Employment type
Time at previous employer years
Time at previous employer months
Previous employer address
Street Address City ZIP / Postal Code Country

Reference Details
Full name*
First Last
Relationship**
Phone*
Reference address
Street Address City ZIP / Postal Code Country

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
Your signature*

Step 1 of 7

Application Details

Purchaser 1 Details

Purchaser 2 Details

Purchaser 1 - Employer Details

Current Employer

Purchaser 1 - Previous Employer

Income

Purchaser 2 - Employer Details

Current Employer

Purchaser 2 - Previous Employer

Reference Details

Assets & Expenses

Assets

Liabilities & Expenses

Recurring household expenditure

Regular recurring essential outgoings

General

General Financial Notes

Insurance

Your insurance policy may contain exclusions from cover, depending on employment status, residency and age.