Applicant DetailsLegal name* First Middle Last Date of birth* GenderMarital status*Number of dependants*If none, enter 0Age of dependantsDriver's Licence DetailsLicence Number*Licence Version Number*Licence Type*FullRestrictedLearnersExpiry Date* Phone and Email DetailsBusiness phone number*Home phone number*Mobile phone number*Email* Enter Email Confirm Email Address DetailsCurrent address*Years at this address*Tenancy*MortgageFreeholdRentingBoardingOtherOther tenancy (details)Previous address*Years at this address*Tenancy*MortgageFreeholdRentingBoardingOtherCitizenship/Visa DetailsAre you a New Zealand Resident?*YesNoDo you have either of the following visas?Permanent Resident VisaTemporary Work VisaTemporary Visa Expiry Date Country of Birth*Other Countries of CitizenshipEmployment DetailsPresent employer*Occupation*Address*Phone*Years*Employment Type*Full TimePart TimeSeasonalSelf EmployedContractorCasualBeneficiaryGST numberPrevious employer*Occupation*Address*Phone*Years*Joint ApplicationIs this a Joint Application?*Yes/NoYesNoOther Applicant's DetailsOther applicant's legal name First Middle Last Date of birth GenderLicence Number (5a)Licence Version Number (5b)Licence TypeFullRestrictedLearnersOccupationPresent employerAddressYearsNext of Kin/Relative's DetailsMust not be currently residing at the same address as the applicant.Legal name* First Middle Last Address*Phone*Relationship*AssetsPlease tick box next to all assets which are jointly owned.Property Value (RV) Property joint asset Furnishings Value Furnishings joint asset Bank Balance Bank joint asset Vehicle Value Vehicle joint asset Do you owe money on your current vehicle/s? Yes No How much is owed?Investments Investments joint asset Other Other joint Liabilities/ExpensesAre you currently paying a mortgage?*YesNoTotal balance of mortgage/s*Mortgage payments (weekly)*Notes about mortgages (if applicable)Are you currently paying rent?*YesNoRent (weekly)*Do you currently have any Hire Purchases, Loans or Credit Accounts?*YesNoTotal balance of Hire Purchase/Loans/Credit Accounts*Please enter each one on new line.Weekly payments of Hire Purchase/Loans/Credit Accounts Payments*Please enter each one on new line.Notes about Hire Purchase/Loans/Credit Accounts (if applicable)Do you currently have a credit card?*YesNoTotal balance of all Credit Cards*IncomeEnter Income after tax.Income below is:* Weekly Fortnightly Monthly Take home pay (after tax)*Your spouse of partner's take-home pay (after tax) (if applicable)Other incomePlease explain other incomeInformation Statement/Authorisation Pursuant To The Privacy Act 1993 Please read this statement notice in full.Have you ever had or are there now any attachments or legal proceeding against you, or any action for payment default?*YesNoIf yes, please state detailsI apply for a loan and certify that the particulars above and overleaf are true and correct and that I am over the age of 18 years and am not an undischarged bankrupt. Pursuant to the Privacy Act 1993 I authorise any finance company to contact any credit reporting agencies, credit providers, my employer(s), accountant(s), or any other source, to obtain, check and exchange (both now and in the future) such personal, financial and commercial information and references about me/us as is necessary for the purposes of considering this application, the protection and administration of any loan arising out of this application, and to assist in the enforcement of any agreement between me/us and any finance company. I agree that you may produce this authority to such parties for the purposes of collecting such information. Under the provisions of the Privacy Act 1993, you are entitled to have access and request correction to personal information held about you. I agree that the information in connection with this finance application may be transmitted via facsimile and/or electronic mail, and I acknowledge that there may be some security risks associated with the transmission. I have read and accept the terms and conditions within this informative statement/authorisation.* I Accept Terms And Conditions Business ManagerWhich Business Manager have you been dealing with at Brendan Foot Supersite? If you aren't sure or haven't been speaking to anyone yet, please tick Unsure.*Catherine BealChelsea WhittingtonEmma WatersSteve HallUnsurePlease ensure the details you have provided above are correct before submitting the application.