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Who we are
Insurance
Contact
Online Application
Rates and Fees
Home
Who we are
Insurance
Contact
Online Application
Rates and Fees
Online Application
Home
Online Application
Online Application
mrd
2018-04-23T03:44:56+00:00
1
First Applicant
2
Second Applicant/Guarantor
3
Confirmation
Personal Info
Name
*
Please include your first, middle and last names, as it appears on your licence
Date of Birth
*
Date Format: DD slash MM slash YYYY
Driver Licence number (5A)
*
Driver Licence Version (5B)
*
Please include numbers from 5A and 5B from your drivers licence
Home Phone
Work Phone
Mobile Number
Email
*
Who is your agent?
*
Damien Taylor
Tracey Gordon
Alan Ebdon
Simon Ryland
Residential Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
What date did you move here?
*
Date Format: DD dash MM dash YYYY
Please indicate below
*
it was less than 2 years ago?
it was more than 2 years ago?
Previous Residential Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Occupation
Employer
What date did you start this job?
*
Date Format: DD dash MM dash YYYY
Please indicate below
*
it was less than 2 years ago?
it was more than 2 years ago?
Previous occupation
Previous employer
Are you GST Registered?
*
Yes
No
GST Number
Nearest Relative
Not Spouse
Relative Residential Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Relative Phone
Close Friend
Close Friend Residential Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Close Friend Phone
Loan Details
What is the reason for your loan?
*
Car
Boat
Home
Motorcycle
Other
If Other - Please state
If Car - Please enter the registration
How much do you want to Loan?
*
Income
Take Home - Monthly
*
Other
Please select your relationship status
*
Single
Married
De Facto
What is your partners monthly income?
Total
Assets
Home
Furnishings
Bank
Other
Liabilities
Mortgage/s
HPs
Credit Cards
Bank Loans / O/Ds
Other
Expenses
Rent/Board
Liabilities Above
Total
Total
Income less expenses
Your Bank Account Details
Bank Branch Name
Bank Account Number
Do you have a second Applicant or Guarantor?
No
Yes
Personal Info
Name
Please include your first, middle and last names, as it appears on your licence
Date of Birth
Date Format: DD slash MM slash YYYY
Driver Licence 5A
Driver Licence 5B
Please include numbers from 5A and 5B from your drivers licence
Home Phone
Work Phone
Mobile Number
Email
Residential Address
Street Address
City
State / Province / Region
ZIP / Postal Code
What date did you move here?
Date Format: DD dash MM dash YYYY
Please indicate below
it was less than 2 years ago?
it was more than 2 years ago?
Previous Residential Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Occupation
Employer
What date did you start this job?
Date Format: DD dash MM dash YYYY
Please indicate below
it was less than 2 years ago?
it was more than 2 years ago?
Previous occupation
Previous employer
Nearest Relative
Not Spouse
Relative Residential Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Relative Phone
Close Friend
Close Friend Residential Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Close Friend Phone
Loan Details
What is the reason for your loan?
Car
Boat
Home
Motorcycle
Other
Other
If Car - Please enter the registration
How much do you want to Loan?
Income
Take Home - Monthly
Other
Please select your relationship status
Single
Married
De Facto
What is your partners monthly income?
Total
Assets
Home
Furnishings
Bank
Other
Liabilities
Mortgage/s
HPs
Credit Cards
Bank Loans / O/Ds
Other
Expenses
Rent/Board
Liabilities Above
Total
Total
Income less expenses
Your Bank Account Details
Bank Branch Name
Bank Account Number
The applicant(s) acknowledge and authorises
The Money Company
or their Agent to collect and hold personal information necessary to process the loan application made by the applicant(s) who are aware that this personal information may be collected from credit reporting agencies, valuers, solicitors, insurance companies/agents, government departments and any other person necessary to process the application including but not limited to Veda Advantage, The Ministry of Economic Development and Land Transport Driver check. The applicant(s) authorises
The Money Company
or their Agent to disclose personal information relating to the applicant(s) to the same individuals, organisations or agencies. The applicant(s) are aware that if all relevant personal information is not supplied then
The Money Company
agent is under no obligation to consider the application. The applicant(s) acknowledges they are aware they have the right of access to and correction of personal information held by
The Money Company
or their Agent.
In order for The Money Company Ltd to complete your request for finance, you will need to print and sign the relevant privacy act document below and return by fax or scan/email using the below contact details.
Business Privacy Act Authority
Individual Privacy Act Authority
Email. damien@themoneycompany.co.nz
Confirmation
*
I confirm that all my data entered is correct and that I accept and agree to the above Terms & Conditions
CAPTCHA
