Applicant Type: (Select appropriate box)

BusinessConsumer (individual (s))
Enter company name/number & or sole trader or partnership name (required)


Individual Information


Individual Applicant / Guarantor Details !ot0265862;+W(each of whom may be the person acting for the purpose of the Personal Property Security Act 1999)

Add another applicant?
YesNo

Individual Information for Second Applicant



Address Details


Address & Tenancy:
Owner UnencumberedOwner MortgageRentingParentsOther
Current Address:
Years
Previous Address:
Years

How long you had you been working with your previous employer?:


Personal Reference


Full Name
Relationship to you
Phone
Address
aaa

Form for the other applicant/Spouse


Address & Tenancy:
Owner UnencumberedOwner MortgageRentingParentsOther
Current Address:
Years
Previous Address:
Years

How long you have been working on previous employer?:


Personal Reference


Name
Relationship to you
Phone
Address

Assets & Liabilities


1) A. ASSETS
Home
Bank/Savings
Car(s)
Investments
Other Assets
B. LIABILITIES
Mortgage Balance
HP/Loans
Credit Cards
Bank O/D
Other Liabilities
C. INCOME (Monthly after tax)
Net Income
Spouse Net Income
Other Income
Rental Income
D. EXPENSES (Monthly)
Mortgage / Rent
HP/Loans
Credit Cards
Living Expenses
Other Expenses
Other Information
aaa

Form for the other applicant/Spouse


First Entry
1) A. ASSETS
Home
Bank/Savings
Car(s)
Investments
Other Assets
B. LIABILITIES
Mortgage Balance
HP/Loans
Credit Cards
Bank O/D
Other Liabilities
C. INCOME (Monthly)
Net Income
Spouse Net Income
Other Income
Rental Income
D. EXPENSES (Monthly)
Mortgage / Rent
HP/Loans
Credit Cards
Living Expenses
Other Expenses
Other Information

Vehicle Finance


Vehicle Finance of your spouse


Application Completion


Before completing this application it is a requirement that you read and accept the below Privacy Act Statement.

3. The Privacy Act 1993



I/we authorise Houston Motor Group* to collect, retain and use the personal information about me/us, for the purposes of:

  • Assessing my/our credit worthiness;
  • Attending to the financing, whether directly or indirectly, of my/our contract(s) and enforcing Houston Motor Group's rights thereunder;
  • Marketing and/or informing me/us about the goods and services provided by Houston Motor Group

I/we authorise Houston Motor Group to collect from credit reporting agencies, credit providers, my/our employer(s), accountant(s), relatives, or other person(s) such personal, financial and commercial information about me/us for the said purposes.

I/we authorise Houston Motor Group to provide this information:

  • To any person for the foregoing purposes;
  • to any employees and agents of Houston Motor Group and/or any other person, in any ordinary course of business, for any of the foregoing purposes;
  • To credit agencies for the purpose of maintaining proper or effective records.

I/we acknowledge that if i/we do not provide all or any part of the information requested on this application form, my/our application for finance may be declined. I/we further acknowledge that pursuant to the Privacy Act 1993, I/we have a right of access to information collected by Houston Motor Group about me/us and to request that this information be corrected. The information will be held at the office of Houston Motor Group, 183 Haven Rd, Nelson, New Zealand or the registered offices of any party nominated by Houston Motor Group.

*Houston Motor Group and other associated third parties

To verify your acceptance of the above Privacy act statement please click the checkbox and click the submit button.