Loan Application

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LOAN APPLICATION FORM

Please fill out the form below to apply for a loan from DFS. Once you submit, we'll be in contact to discuss the details and insurance on the loan.

Who is completing this form?*

A Dealer

A Personal Applicant(s)

Dealers Name*

Dealer Email Address*

A copy of this application form will be sent here

Loan Details

Purchase Price*

Extras Cost

Warranty Cost

Deposit Cash

Trade-in Net Value

Amount Financed

Term (Months)

Year Made*

Make*

Model*

Reg No

Number of Borrowers*

A Single Borrower

Co-Borrowers/Spouses

Are you trading in another vehicle?

Yes

Is the Trade-in Encumbered?

Yes

I.e. Is there money owing to another lender

Encumbered to Whom?*

Amount Encumbered*

Trade-in Vehicle Make*

Trade-in Vehicle Model*

Trade-in Vehicle Reg No

Primary Borrower Details

Name*

Prefix

First

Last

Relationship Status

Date of Birth*

Email address*

A copy of this application form will be sent here

Mobile or Primary Phone Number*

How we should contact you

Home Phone Number

Work Phone Number

Current Address*

Situation*

Years at*

Situation at Previous Address*

Previous Address*

Years at Previous Address*

Situation at Previous Address*

Previous Address*

Years at Previous Address*

Employment History

Current Occupation*

Current Employer Name*

Years at Current Job*

Previous Occupation*

Previous Employer Name*

Years at Previous Job*

Previous Occupation*

Previous Employer Name*

Years at Previous Job*

Number of Dependants*

List the age of each dependant

License Information

NZ or Overseas Resident?

NZ Driver's License No. (5a)

Version No. (5b)

Expiry Date (4b)

Country of Birth

Co-Borrower/Spouse Details

Name*

Prefix

First

Last

Relationship Status

Date of Birth*

Email address*

A copy of this application form will be sent here

Mobile or Primary Phone Number*

How we should contact you

Home Phone Number

Work Phone Number

Current Address*

Situation*

Years at*

Situation at Previous Address*

Previous Address*

Years at Previous Address*

Situation at Previous Address*

Previous Address*

Years at Previous Address*

Employment History

Current Occupation*

Current Employer Name*

Years at Current Job*

Previous Occupation*

Previous Employer Name*

Years at Previous Job*

Previous Occupation*

Previous Employer Name*

Years at Previous Job*

Number of Dependants*

List the age of each dependant

License Information

NZ or Overseas Resident?

NZ Driver's License No. (5a)

Version No. (5b)

Expiry Date (4b)

Country of Birth

References

Next of Kin - Full Name

Next of Kin - Phone Number

Next of Kin - Address

Personal Reference - Full Name

Personal Reference - Phone Number

Personal Reference - Address

Figures Presented Below As*

Primary Borrower - Average Net Income

Applicant's Income*

Spouse's Income

Other Income

Primary Borrower - Average Net Expenses

Mortgage / Rent / Board*

Other Payments / Bills

Loan Repayments / HPs

Home(s)

Vehicle(s)

Bank Savings

Furniture / House Hold Items

Other Assets

Mortgage Debt

Mortgage - Bank Name

HPs / Loans - Total Balance

Credit Cards / Bank ODs

Other Liabilities

Figures Presented Below As*

Co-Borrower/Spouse - Average Net Income

Applicant's Income*

Spouse's Income

Other Income

Co-Borrower/Spouse - Average Net Expenses

Mortgage / Rent / Board*

Other Payments / Bills

Loan Repayments / HPs

Home(s)

Vehicle(s)

Bank Savings

Furniture / House Hold Items

Other Assets

Mortgage Debt

Mortgage - Bank Name

HPs / Loans - Total Balance

Credit Cards / Bank ODs

Other Liabilities

Attachments

Clear Copy of Driver's Licence (Restricted or Full)

Proof of Address (E.g. Recent Utility Bill)

Proof of Income (E.g. Recent Payslip/Bank Statement)

Copy of Full Cover Insurance

Privacy Act

I/we certify that the particulars above and overleaf/below are true and correct and that I/we am/are over the age of 18 years and are not an undischarged bankrupt. Pursuant to the Privacy Act 1993 I/we authorise any finance company to contact any credit reporting agencies, credit providers my/our 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 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.

Primary Borrower Signature

Co-Borrower/Spouse Signature

Date

This field should be left blank

Cars 4u HB ltd was formed by Regan Munro in 2018 to provide affordable motor vehicles with options for motor vehicle purchases under financing. We have over 20 years in the motor industry in sales and finance

+6421557400

[email protected]

306 Eastbourne Street West Hastings