Finance Application

Borrower 1
Title
Surname:	*
First & Middle Name(s):	*
Address:	*
	*
Email:	*
Phone (Mobile):	*
Phone (Home):	*
Phone (Work):	*
Occupation:	*
Employer:	*
Employer Address:	*
How Long?:	*
Previous Employer:	*
Previous Employer How Long:	*
Credit Reference:	*
Ministy of Justice Fines?
Date of Birth:	*
Insurance Company:	*
Drivers Licence #:	*
Licence Version #:	*
Licence:
Residence:
How long have you lived here?	*
Marital Status:	*
Dependants:	*
Ages:	*
Nearest Relative (not spouse):	*
Relative Address:	*
Relative Mobile:	*
Relative Home Phone:	*

Borrower 2 / Guarantor
Title
Surname:
First & Middle Name(s):
Address:

Email:
Phone (Mobile):
Phone (Home):
Phone (Work):
Occupation:
Employer:
Employer Address:
How Long?:
Previous Employer:
Previous Employer How Long:
Credit Reference:
Ministy of Justice Fines?
Date of Birth:
Insurance Company:
Drivers Licence #:
Licence Version #:
Licence:
Residence:
How long have you lived here?
Marital Status:
Dependants:
Ages:
Nearest Relative (not spouse):
Relative Address:
Relative Mobile:
Relative Home Phone:

Finance Proposal
Purchase Price:	$ *
Deposit / Trade In:	$ *
Finance Amount:	$ *
Traded:	*
Term:	*
Vehicle Make:	*
Vehicle Model:	*
Registration No:	*
Year:	*
Colour:	*
CC Rating:	*
Kilometres:	*
Dealer:	*

Financial Details
Budget Period:

INCOME
Ordinary Net Income of Applicant:	$ *
Other Income:	$ *

Ordinary Net Income Joint/Guarantor:	$ *
Other Income:	$ *

Total Income:	$ *

EXPENDITURE
Rent / Mortgage / Board:	$ *
Other Loans:	$ *
Hire Purchases:	$ *
Credit / Store Cards:	$ *
Bank:	$ *
Limit:	$ *
Home / Contents / Car Insurance:	$ *
Life Insurance / Superannuation:	$ *
Child Support / Maintenance:	$ *
Vehicle Running Costs:	$ *
Electricity / Gas / Phone:	$ *
Food / Groceries / Clothing / Footwear:	$ *

Total Expenditure:	$ *

Total Surplus / Deficit:	$ *

Assets and Liabilities
ASSETS
Bank Accounts:	$ *
Properties:	$ *
Vehicles	$ *
Other Assets	$ *

Total Assets:	$ *

LIABILITIES
Mortgage:	$ *
Car Loan(s):	$ *
	$ *
	$ *
Overdraft Limit:	$ *
Credit / Store Card Limit(s):	$ *
	$ *
	$ *
Other Liabilities:	$ *

Total Liabilities:	$ *

Net Worth:	$ *


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Finance Application

Borrower 1

Borrower 2 / Guarantor

Finance Proposal

Financial Details

INCOME

EXPENDITURE

Assets and Liabilities

ASSETS

LIABILITIES