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Southern Finance Ltd
183 Montreal Street
P O Box 22-321
Christchurch
Fax: 03 379 9744

Personal Details

 
 
 
 
 
 

Current Employment

 
 
 

Joint Application Details

 
 
 
 
 

Joint Applicant Current Employment

   
 
 
 

Joint Finances

INCOME (Monthly)

EXPENSES (Monthly)

 
 
 

Assets

Liabilities

 
 
 
 

Next Of Kin Not Living With You

 
 
 
 

Bank Details

Branch
   
  Joint Applicants Bank Branch
     

Credit Reference Details

Which of These Do You Have?




Credit References (Finance Co, Dept. Store, Hire Purchase, etc. (Current or finalised in the last last 12 months))

General Loan Information

Have you ever been admitted to the "No Asset Procedure," adjudicated Bankrupt or had money demanded from you from a debt collection agency?


Have you been sued?


Have you got a criminal record?


General Loan Information


What You Can Offer As Security Or Collateral?

Details Of Vehicle Being Purchased (if applicable)

(A)
(B)

Other Motor Vehicles Owned

How Did You Hear About Southern Finance?

     

Declaration

Declaration: I / We have read, fully understand and agree with the Privacy Acknowledgement This must be marked as 'Yes' in order for your application to be considered

Privacy Act 1993

I/We:
  • acknowledge that the information supplied by me/us in this confidential statement will be used by SFL to assess my/our suitability as guarantors.
  • agree that SFL may collect from credit reporting agencies, credit providers, my/our accountants or legal representatives such personal, financial and commercial information about me/us as is necessary for the purpose of assessing my/our suitability as guarantors.
  • authorise SFL or any SFL related company to send or advise me/us details of other products and services from time to time.
  • authorise SFL to give and receive any information regarding my/our financial affairs and this enquiry/request may be exchanged with nominated financiers/agents or any of their subsidiaries.
  • I/We acknowledge that if SFL provides the finance subject to my/our guarantee, SFL
  1. will keep the personal information during the period the finance is provided and for a period of six months after repayment of all credit provided by SFL.
  2. may collect and monitor personal information about me/us as is necessary for the administration and protection of such credit; and
  3. may provide any of the personal information to a third party employed by SFL to assist in the enforcement of any agreement between us.
  4. Where the personal information may be readily retrieved, I/we shall have access to it and the right to request correction.
Signed: ___________________ Date: __ /__ / __ ( Day / Month / Year )

Signed: ___________________ Date: __ /__ / __ ( Day / Month / Year )

(please sign if you are sending this form by post)