Personal Application Form NOTE: If you are completing this as a joint application, co-borrowers must use this form PURCHASE INFORMATION Vehicle Details: Year / Make / Model Vehicle Registration If applicable Purchase Price $ Deposit $ Trade-in Details: Year/ Make/ Model Trade In Vehicle Registration If applicable Trade In Price $ APPLICANTS DETAILS Applicants First and Middle Name/s * Your First and Middle Name/s as on your Driver's License Applicants Surname * Your Surname as on your Driver's License Other Names Used Family Name, Also Known As Date of Birth * MM DD YYYY Country of Birth * New Zealand Resident? * Yes No Country of Citizenship Marital Status * Single De-facto Married Divorced Widowed Gender * Male Female Other Prefer not to say Home Phone Mobile * Email * Dependent Children (Under the Age of 18) Please List your Dependents Ages Driver's Licence / ID type * Please use a Driver's Licence unless you do not have one Full Restricted Learner International Passport Other Driver's Licence / ID Number * Driver's Licence Version Number * Driver's Licence / ID Expiry Date * MM DD YYYY ADDRESS INFORMATION Tenancy type * Own home Renting Boarding Supplied by Employer Living with Relatives Current Address * Address 1 Address 2 City State/Province Zip/Postal Code Country How Many Years Have You Lived There? * 0 1 2 3 4 5 6 7 8 9 10+ How Many Months Have You Lived There? * 0 1 2 3 4 5 6 7 8 9 10 11 Previous Address Only complete this section if you have lived in your current address for less than 3 years Previous Suburb Previous City Previous Postcode How Many Years Did You Live There? 0 1 2 3 4 5 6 7 8 9 10+ How Many Months Did You Live There? 0 1 2 3 4 5 6 7 8 9 10 11 CONTACTS 1 contact must be related and 1 can be a friend or relative. All contacts must live at a different address from you Nearest Relatives Name * First Name Last Name Relatives Phone Number * Relationship To You * Second Contacts Name * First Name Last Name Second Contacts Phone Number * Relationship To You * EMPLOYMENT INFORMATION Employment Type * Tick all that apply Full-Time Part-Time Self-Employed Fixed-Term Contract Casual Student Beneficiary Pensioner Current Employer * Position Held * Current Work Address * City How Many Years Have You Worked There? * 0 1 2 3 4 5 6 7 8 9 10+ How Many Months Have You Worked There? * 0 1 2 3 4 5 6 7 8 9 10 11 Current Work Phone Number * Previous Employer Only complete this section if you have worked at your Current Workplace for less than 3 years Previous Position Held Previous Work Address Previous Work City How Many Years Did You Work There? 0 1 2 3 4 5 6 7 8 9 10+ How Many Months Did You Work There? 0 1 2 3 4 5 6 7 8 9 10 11 FINANCE DETAILS INCOME: (AFTER TAX AND ALL DEDUCTIONS) How Often Do You Get Paid? * Weekly Fortnightly Monthly Your Income * $ Spouse's Income Proof may be required $ Government Benefit Job Seeker Working For Families Solo Parent Superannuation Sickness/Disability Benefit Accommodation Suppliment Student Allowancve Family Tax Credit Other Source 1 $ Other Source 2 $ Are you a KiwiSaver Member? * Yes No If you selected 'Yes', what is your % contribution AVERAGE PERSONAL EXPENSES Your Contribution How Often Are These Expenses? Weekly Fortnightly Monthly Rent $ Mortgage: Company Mortgage: Balance $ Mortgage: Payments $ Loan 1: Company Loan 1: Balance $ Loan 1: Payments $ Loan 2: Company Loan 2: Balance $ Loan 2: Payments $ Loan 3: Company Loan 3: Balance $ Loan 3: Payments $ Loan 4: Company Loan 4: Balance $ Loan 4: Payments $ Credit Card 1: Company Credit Card 1: Limit $ Credit Card 1: Balance $ Credit Card 1: Payments $ Credit Card 2: Company Credit Card 2: Limit $ Credit Card 2: Balance $ Credit Card 2: Payments $ Overdraft: Company Overdraft: Balance $ Overdraft: Limit $ Overdraft: Payments $ Are You Currently A Guarantor/Co Borrower For Another Person? * Yes No If you selected 'Yes', who is the Debt Owing to? Rough balance $ Payments $ ASSETS Home: Value $ Investment Property/s: Value $ Vehicle 1 Details: Year / Make / Model Vehicle 1 Details: Registration If applicable Vehicle 1: Value $ Vehicle 2 Details: Year / Make / Model Vehicle 2 Details: Registration If applicable Vehicle 2: Value $ Savings: Value $ KiwiSaver: Value $ Chattels/Contents: Value $ Other: Please explain Other: Value $ YOUR SHARE OF EXPENSES FORM Frequency of Expenses * Weekly Fortnightly Monthly LIVING EXPENSES Examples of regular Living Expenses: Groceries/Takeaways, Insurance Premiums, Transport Cost (Fuel, WOF, Rego), Childcare, Child Support, Rates and Body Corporate Fees, Utilities (Mobile, Internet, Power), Clothing and Personal Care, Entertainment, Health and Medical Services, Tithing, Overseas Remittances or any Regular Expenses that you pay Amount: $ WINZ WINZ Repayments $ WINZ Re-Direction $ Other WINZ Payments $ FINAL QUESTIONS In The Past 5 Years, Have you Had Any Payment Defaults * Yes No If you selected 'Yes', which Companie/s did you defaulted to? Would You Prefer Payments * Weekly Fortnightly Monthly Payment Amount You Are Comfortable With * $ Preferred Date Of First Payment MM DD YYYY I authorize Good Lending (and any associated Finance Companies ) to contact any Credit Reporting Agencies, Credit Providers, my Employer, Ministry of Justice or any other source to obtain, check and exchange such personal, financial and commercial information and references about me as is necessary for the purposes of considering this application. I agree that Good Lending (and any associated Finance Companies ) may in the future provide information to associated parties for the purposes of collecting information for the protection and administration of any loan arising out of this application, and to assist in the enforcement of any agreement between Good Lending and/or any finance company. Under the provisions of the Privacy Act 1993, you are entitled to have access to and request correction of personal information held about you. * I agree I disagree If you have ticked I disagree, please explain in more detail. Todays date * MM DD YYYY Thank you!
