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Finance Application
Personals  
Name: Contact & Phone No. Date In: Time In: Date Out: Time Out:
 
Asset  
Make/Year  Model Transmission Reg no.:  Body 
 
Chassis/Ser no.: Engine no: 
 
Extras:
 
Details of towing unit if goods towable:
Dep%:
 
Trade In 
 
Make/Year  Model Transmission Body 
 
Engine Cap. Engine No.: Value $:  Pay out $: Company: 
 
 
Customer(s)    Guarantor(s)   Separate application forms required             
Surname/CO Name: Given Names:  .Title: 
    
Street: 
 
Suburb State:  Postcode:  Years at this address: 
 
Previous address:  Years:
 
Mailing address? DOB: (DD/MM/YY) Marital Status: No. Dependents:
YesNo
 
Licence No.  Expiry Date: Home Phone No. Business Phone No. 
 
Customer No.:  Spouse: DOB:
 
Home   
Monthly Payment$  Mortgagee/Landlord Value$ Balance$ 
 
Occupation 
Self Employed  Nature of business: 
 
Present Employer  Address Yrs  Position  Net Monthly Wage $ 
 
Previous Employer Address Yrs  Position  Net Monthly Wage $ 
 
Spouse Employer  Address Yrs  Position  Net Monthly Wage $ 
 
Closest Relative - not living with applicant            
Name  Address Relationship  Phone No.
 
References Bank 
Name  Branch  Cheque: Savings: Bankcard:
 
Accountant 
Name Address Phone No.
   
H.P Lease, P.Loans  
Company Name Account No.  Address  Curr. Fin.  Type
 
Company Name Account No.  Address  Curr. Fin.  Type
 
Company Name Account No.  Address  Curr. Fin.  Type
 
References  
Trade Address Phone No. 
 
Trade Address Phone No. 
 
Personal Address Phone No. 
 
 
 
 
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