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PERSONAL DETAILS





AMOUNT REQUIRED

Total Deposit: $

Amount Financed: $


DESCRIPTION OF GOODS

VEHICLE/ASSET BEING PURCHASED



YOUR CAR TRADE-IN DETAILS (Leave blank if no trade-in)



EMPLOYMENT DETAILS






References




FINANCIAL DETAILS

Average Monthly Net Income

Average Monthly Expenditure

Total Expenditure: $

Statement Of Financial Position

Assets

Total Assets: $

Liabilities

Total Liabilities: $

Privacy Act

Privacy Act 1993 Declaration: I/We confirm that information about me/us may be disclosed to Bespoke Financing Limited, its related companies, agents, assigns, associates & transferees (Bespoke). I/We irrevocably authorise any person/persons to provide you with such personal information concerning me/us as you may require in response to your credit and/or employment enquiries. I/We further irrevocably authorise you to furnish to any lender or third party any personal information concerning me/us including details of this application and any subsequent dealings that I/We may have as a result of this application being actioned by you. I/We further authorise such lender or third party to make further enquiries and present my information to use the Equifax or Centrix credit reporting services to obtain a credit check (now or in the future) which may be necessary in connection with this application and any agreement I/We may enter into as a result of this application. Equifax/Centrix will give us the resultant information (a credit check). When other customer’s use these services, this information may be disclosed to them. I/We authorise you to obtain information from the Ministry of Justice about outstanding fines, and my/our consent is given to obtain and access driver licence records using NZTA’s Driver Check service. Where the personal information may readily be retrieved. I/We shall have access to it and the right to request correction. I/We apply for the above loan and certify that the particulars supplied above are true and correct, and that I/We are over 18 years and I am/We are not an undischarged bankrupt.