TitleMr.Mrs.Miss.First Name *Middle NameSurn Name *GenderMaleFemaleUnknownMarital StatusSingleMarriedUnknownEmail Address *Mobile No *Phone HomePhone WorkDate Of BirthDrivers Licence(Requiredr Loan)FullRestrictedLearnersInternationalNot HeldUpload Drivers License ImagesChoose FileNo file chosenDelete uploaded fileBest time and phone number to contactNZ Resident (If no, we will require a co-borrower who is a permanent resident)YesNoYesNoHow many dependent children do you have?000102030405Current AddressCurrent Address StatusChoose....BoardingRentingOwn a House with a mortgageOwn a House that is FreeholdHow long have you been living here?Choose....0 Years1 Years2 Years3 Years4 Years5 Years6 Years7 Years8 Years9 Years10+ YearsHow long have you been living here?Choose....0 Months1 Months2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 MonthsCurrent OccupationCurrent EmployerEmployed StatusEmployed StatusFull TimePart TimeSelf EmployedUnemployedBeneficiaryRetiredHow long have you been working there?Choose....0 Years1 Years2 Years3 Years4 Years5 Years6 Years7 Years8 Years9 Years10+ YearsHow long have you been working there?Choose....0 Months1 Months2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 MonthsComments / QuestionsWhere Did You Hear About CR Auto MotorsFriend or RelativeFacebookBillBoardGoogleRadioMortgage AdvisorOtherLOAN DETAILSLoan AmountDETAILS – VEHICLE TO BE PURCHASEDMakeYearModelColorRegistration NumberDETAILS – TRADE IN VEHICLEMakeYearModelColorWarrant of Fitness ExpiryRenewal of Vehicle Licence (rego) Due DateUpload Images of Your VehicleDrag and Drop (or) Choose FilesMax file size: 9.77 MB. | Allowed file types: gif,jpeg,png,jpg,pdf | Max number of files: 10DETAILS OF YOUR INCOMEIncome AmountIncome TypeChoose....Salary or WagesBenifit IncomeSelf Employed IncomeSeasonal IncomeRetirement IncomeUnknownOtherIncome FrequencyChoose....WeeklyFortnightlyMonthlyTotal IncomeHOUSING EXPENSESMortgage / Rent / Board ExpensesFrequencyChoose....WeeklyFortnightlyMonthlyExisting Loan repayments / HPs / Credit Cards ExpensesExpense FrequencyChoose....WeeklyFortnightlyMonthlyYOUR ASSETSAsset TypeChoose....PropertyHousehold AssetMotor VehicleSavingsSharesOthersValueMoney OwingRepaymentFrequencyChoose....WeeklyFortnightlyMonthlyLIABILITIESLiabilitie TypeValueMoney OwingRepaymentFrequencyChoose....WeeklyFortnightlyMonthlyAcceptance of Terms and Conditions Privacy Act Authorisation 1. CR Auto Motors Ltd (hereinafter referred to as “we” and “us”) need to collect private information from you, from others and share your information with others to: assess your application for credit; help us administer any loan and/or security you have with us; enforce or defend our rights or collect any money owed by you; offer a service or market a product to you that is either our product or a product that we market or administer; conduct market research, where the information is combined with other information and in a form that does not identify you; meet our internal operational requirements, such as for credit and risk management, system or product development and planning, insurance, audit and administrative purposes; and facilitate the transfer or assignment of our rights. 2. By signing this authority, you consent and authorise us and any referring broker or motor vehicle dealer to: Note: if you do not consent your application will not be able to be considered by CR Auto Motors. Provide your personal information to a credit reporter, including Equifax New Zealand Information Services and Solutions Limited or Illion, for identity verification, credit reporting (including for comprehensive credit reporting), monitoring services, or lodging a default on your credit file both now and in the future. Obtain information from, or provide personal information to, the Ministry of Justice to find out whether you have any outstanding fines. Obtain and access your driver licence record using NZTA’s Driver Check service both now and in the future including receiving notifications from Driver Check if information about your driver licence changes. Share your driver licence information with a credit reporter and/or the Ministry of Justice. Disclosure of your driver licence number to a credit reporter or the Ministry of Justice is voluntary so you can ask us not to disclose it in writing when you complete this authorisation. Make disclosure of any personal information to any third party that provides services to us including but not limited to any bank, government department or agency, law firm, other professional, debt collection agency, market research firm, insurer, potential assignee, transferee or other person whom we anticipate entering into contractual relations in connection with this loan, any third party who has or may have a financial interest in this loan, or any other person or organisation authorised by you, who has agreed to only collect, hold, use, and share your personal information for the purposes for which it has been given to them. Disclose and receive your personal information, including but not limited to details of this loan, any associated loan application, any financial dealings you may have with us, your address, telephone number(s), the place where you work, details of your income and any convictions you may have, with the organisations set out in this clause and in relation to the purposes described in clauses 1. You have a right to ask us not to use your personal information for the purpose of marketing or offering a service to you. 3. You have the right to know the agencies that may hold your personal information and a right to correct it if it is wrong. The addresses of agencies that may hold your personal information are: Electronic Communications You consent to us communicating with you electronically with respect to your application and/or loan. You also consent to us sending you marketing material and/or messages electronically or otherwise, even after you have repaid your loan in full. Declaration You declare and certify that you have read and understood this authorisation and the loan documentation, the information provided is true and correct in all respects, you are not an undischarged bankrupt and you are no less than 18 years of age and that you have disclosed any other names that you are currently known as and you are aware that if you have deliberately provided false information in this application you could face fraud or dishonesty charges in a Court.Please read and agreed to the Privecy Statement *I have read and agreed to the Privecy Statement Submit