ONLINE LOAN APPLICATION...

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1. PERSONAL DETAILS:

Full name (Mr/Mrs/Miss/Ms) *

Birth date *//

Partners name (Mr/Mrs/Miss/Ms)

Birth date //

Residential address *

Suburb *

Post code *

Postal address (if different from above)

Suburb

Post code

Home number *

Mobile number *

Business number *

Fax

Email *

Drivers licence No. (5a) *

Marital status *

Number of dependents

Ages

Please select *

Years *

Your occupation *

Employer’s name *

Employer’s address *

Years *

Previous employer *

Years *

Partners employer

Years *

2. CONTACT DETAILS: (must be 3 different contacts)

NEXT OF KIN

Full name *

Relationship to you *

Phone number *

Address *

Suburb *

Post code *

NEAREST RELATIVE NOT LIVING WITH YOU

Full name *

Relationship to you *

Phone number *

Address *

Suburb *

Post code *

ALTERNATIVE CONTACT

Full name *

Relationship to you *

Phone number *

Address *

Suburb *

Post code *

3. FINANCIAL DETAILS

Joint weekly income (Net of tax & excluding overtime) *

Please provide evidence of your income *

Bank *

Branch *

A/C Number *

Balance *

OUTGOINGS:

Please select *

HP *

Credit cards *

Loans *

Power *

Phones *

Rates *

Food *

Insurances *

Other *

Dependent support *

This loan *

Please check you have provided: *

Bank statement
Proof of income
ID Verification

Bank Statement attachment *

ID Verification attachment *

4. CREDIT DETAILS

JOINT EXISTING HIRE PURCHASES / LOANS & CREDIT CARDS:

Company

Item

Balance

Repayments

Company

Item

Balance

Repayments

Company

Item

Balance

Repayments

Credit References

Please attach THREE WRITTEN credit references from existing / past financial institutions or businesses who have advanced goods on credit. References provided will assist in speedy application assessment.

1. Credit reference or payment history *

2. Credit reference or payment history *

Have you ever been bankrupt? *

If so, when were you discharged?

Evidence file attachment

Have you been taken to court for debt recovery purposes? *

If so, please provide details.

Have you ever had goods repossessed? *

If so, please provide details.

Are you insured? *

Are your vehicle insured? *

If so, please state which company.

5. LOAN DETAILS

Amount required *

Repayments (Weekly) *

Purpose of loan *

Guarantor

A guarantor may be required before this loan may proceed, a Guarantors Application will also need to be completed in this instance. The nominated guarantor will then be required to sign a written guarantee (contract supplied later) BEFORE monies will be advanced.

Guarantor’s full name

Phone number

Relationship to applicant

Address

Suburb

Post code

Security

Please supply details of a vehicle that can be used for security on your loan. PLEASE PROVIDE A (PHOTO)COPY OF YOUR CERTIFICATE OF REGISTRATION WITH THIS APPLICATION, OR PROVIDE THE FOLLOWING.

Vehicle make

Vehicle model

Vehicle year

Vehicle registration

Vehicle Chassis / Vin

6. PRIVACY ACT & CREDIT REPORTING PRIVACY CODE DECLARATIONS

I / we understand that you Embassy Finance Ltd are asking me for personal information about me for the following purpose’s:

6.1 You will give my personal information to Veda Advantage NZ Ltd’s credit reporting service to credit check me, and Veda Advantage NZ Ltd will give you information about me for that purpose. Veda Advantage NZ Ltd will hold that information on their systems and use it to provide their credit reporting service.

6.2 When other Veda Advantage NZ Ltd customers use the Veda Advantage NZ Ltd credit reporting service, Veda Advantage NZ Ltd may give the information to those customers.

6.3 You may use Veda Advantage NZ Ltd ‘s credit reporting services in the future for purposes related to the provision of credit to me. This may include using Veda Advantage NZ Ltd’s monitoring services to receive updates if any of the information held about me changes.

6.4 If I default in my payment obligations to you, information about that default may be given to Veda Advantage NZ Ltd, Veda Advantage NZ Ltd may give information about my default to other Veda Advantage NZ Ltd customers.

6.5 “I / we authorise any person or company to provide you with such information as you may require in response to credit and / or employment inquiries. I / we authorise you to furnish to any third party details of this application and any subsequent dealings that I / we have with you as a result of this application being actioned by you.”

6.6 “I / we understand that the above information will be stored by Embassy Finance Ltd at Canada Street, Morrinsville for the purposes of this loan, that I / we may access that information and request correction of its details.”

I accept the terms and conditions *

Signatures *

Date *

Comment

It couldn't be easier!

Or Call Us On 07 889 5029

ONLINE LOAN APPLICATION...

Apply for a loan now!

1. PERSONAL DETAILS:

2. CONTACT DETAILS: (must be 3 different contacts)

NEXT OF KIN

NEAREST RELATIVE NOT LIVING WITH YOU

ALTERNATIVE CONTACT

3. FINANCIAL DETAILS

OUTGOINGS:

4. CREDIT DETAILS

JOINT EXISTING HIRE PURCHASES / LOANS & CREDIT CARDS:

Credit References

Please attach THREE WRITTEN credit references from existing / past financial institutions or businesses who have advanced goods on credit. References provided will assist in speedy application assessment.

5. LOAN DETAILS

Guarantor

A guarantor may be required before this loan may proceed, a Guarantors Application will also need to be completed in this instance. The nominated guarantor will then be required to sign a written guarantee (contract supplied later) BEFORE monies will be advanced.

Security

Please supply details of a vehicle that can be used for security on your loan. PLEASE PROVIDE A (PHOTO)COPY OF YOUR CERTIFICATE OF REGISTRATION WITH THIS APPLICATION, OR PROVIDE THE FOLLOWING.

6. PRIVACY ACT & CREDIT REPORTING PRIVACY CODE DECLARATIONS

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