Finance Application

Know What You Want to Finance?

Start adding things to your cart then fill out the application.

Title *

Firstname *

Lastname *

Gender *

Male

Female

Date Of Birth *

Mobile Phone Number *

Email Address *

Choose A From of identification *

NZ Drivers Licence

NZ Passport

Overseas Passport with NZ Visa

Australian Passport

Identification Expiry Date *

Identification Number *

Licence Version *

Country Of Issue *

Permanent Resident *

Yes

Work Visa

Born In New Zealand *

Yes

Years in NZ

Your Street Address *

City *

Living Situation *

Landlords Name *

Landlords Street Address *

City *

Landlords Phone *

*Please note your landlord is not contacted as part of the application process.

Time At Address *

Years

Months

Previous Street Address *

City *

Employment Type*

Accountant's Name *

Accountant's Contact Person *

Accountant Phone *

Job Title *

Employers Name *

Employers Street Address *

City *

Employers Phone *

Time At Current Job *

Years

Months

Previous Employers Name *

*Please note your employer is not contacted as part of the application process.

Monthly Income *

Accomodation Cost (Monthly) *

Loan Repayments (Monthly) *

Living Expenses (Monthly) *

Cards Held

Amex

Diners

Master Card

Visa

Farmers Finance

Ge Creditline

Gem Visa

QCard

Debit Card

Card Limit Required *

Marital Status *

Partners Income (Monthly) *

Number of Dependent Children Under 18 *

Alternative Contact Name (not at same address, can be a relative or referee*) *

Alternative Contact Phone Number *

Relationship with Alternative Contact*

Alternative Contact Street Address*

Alternative Contact City*

Preferred Finance Provider:

Q Card

Finance Now

I Agree to the terms and conditions

Please complete all required fields

Finance Application

Know What You Want to Finance?

Personal Details

Identification

Address

Employment

Financial Information

Confirmation

Know What You Want to Finance?