Online Application

Please Complete All fields in Full

Please use the web based application form below, alternatively you can use our printable form:

Application Form

Web Form:

General Loan Information:

What type of finance are you applying for?:

Who is borrowing the money?:

Amount required:

Deposit:

Details of Goods:
Please provide information based on the following Criteria:

If Vehicle:
Make
Model
Year
Reg
Mileage

If horse/Pony:
Breed
Age
Mare/Gelding
Size
Colour

Supplier:

Term required:

____________________________________________________

Personal Information - Primary Applicant:

First name:

Middle name(s):

Last name:

Date of Birth:

NZ Citizen or Permanent Resident:

Marital status:

Number of dependants:

Driver's Licence:

Driver's Licence Number:

Current Residence:

Current Home Address:

Years at Current Address:

Previous Home Address:
(If current address less than 2 years)

Years at Previous Address:

Home Phone Number:

Mobile Phone Number:

Work Phone Number:

Email Address:

Employment Information - Primary Applicant:

Employment Status:

Current employer:

Occupation:

Years:

Previous employer:

Occupation:

Years:

Relative Reference (family member) - Primary Applicant:

Nearest Relative Reference (name):

Relationship:

Address:

Phone:

Personal Reference (non family member) - Primary Applicant:

Name:

Address:

Phone:

Personal Information - Second Applicant:
(If Application)

Check this box if there is a second applicant:

First name:

Middle name(s):

Last name:

Date of Birth:

Driver's Licence:

Driver's Licence Number:

Private Reference:

Address:

Phone:

Employment Information - Secondary Applicant:
(If Application)

Employment Status:

Current employer:

Occupation:

Years:

Previous employer:

Occupation:

Years:

____________________________________________________

Financial Information - Income
(Monthly)

Applicant Take Home Pay:

Spouse's Take Home Pay:

Other Income:

Total Income:

Financial Information - Expenses
(Monthly)

Mortgage/Rent:

Rates/Insurance/Phone/Power:

HP/Credit Cards:

Life Insurance/Building Society :

Car/Other Expenses

Total Expenses:

____________________________________________________

Financial Information - Assets
(Please note all assets that are jointly owned)

Home:

Furnishings:

Bank:

Car:

Investments:

Other:

Total:

Financial Information - Liabilities

Mortgages - Address As.. :

HP/Credit Cards :

Bank Over Draft :

Other Creditors/Loans :

Total Liabilities:

____________________________________________________

Assets offered as Security (may not be required):

Vehicle:

Make:

Model:

Year:

Registration Number:

Mileage:

Value:

Encumbered to:

Other:

____________________________________________________

Additional Comments:

____________________________________________________

Privacy Act 1993
I/We
a) declare the above information is true and correct and that I am/we are over the age of 18 years and I am/we are not an undischarged bankrupt/s;
b) authorise you (Equestrian Finance) to send this application to any third party (the FINANCE COMPANY): and
c) agree the FINANCE COMPANY may collect from credit reporting agencies, credit providers, my/our employers/s, accountant/s, or other named person/s or relative/s, such personal, financial and commercial information and references about me/us as is necessary for the purposes of considering this application.
And I/we agree that you may produce this authority to such parties for the purposes of collecting such information.
d) I/we agree to meet the cost of an independent valuation of the security to support this application such valuation to be obtained by you in consequence of this applicant. My/our solicitor/agent is authorised to accept any notification on my/our behalf.
e) I/we declare that the above information is true and correct in every particular and it is upon this basis that I/we make this application.

I/We acknowledge that if the FINANCE COMPANY provides this finance the FINANCE COMPANY:
a) will keep the personal information during this period the finance is provided and for six months after repayments of all credit provided by the FINANCE COMPANY:
b) may collect and monitor personal information about me/us as is necessary for the administration and protection of such credit: and
c) may provide any of the personal information to a third party employed by the FINANCE COMPANY to assist in enforcement of any agreement between us.
d) I/We request the FINANCE COMPANY or any related finance company to send me/us details of other products and services from time to time.

Where the personal information may readily be retrieved, I/WE shall have access to it and the right to request correction.

Provision of Additional Services
I authorise the FINANCE COMPANY to disclose personal information about me to a credit agency for the purposes of compiling a credit report, creating a credit profile, merchandising, market research and offering additional services including newsletters from Equestrian Finance or the offer of additional credit facilities. The information that may be disclosed includes:
name, address and telephone number; the loan amount of any facility; any debits made; the frequency and amounts of payments made including details of overdue payments. I understand that I have the right to access and request correction of my personal information held by the credit reporting agency.

____________________________________________________

I have read and understood the terms and conditions:
(check box for yes)

Where did you hear about us:

If advert which magazine:

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