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Loan Details
 months
Applicant Details
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Drivers Licence
Learners Restricted Full
Learners Restricted Full
Contact Details
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( )
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Address Details
Employment Details
Alternative Contacts
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( )
Account References (HP/Credit Card etc.)
Financial Details

Assets (please note all jointly owned assets)

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Liabilities

$
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Income (monthly)

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$

Expences (monthly)

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PRIVACY ACT 1993 ACKNOWLEDGEMENT AND AUTHORISATION FOR COLLECTION, USE AND DISCLOSURE OF INFORMATION

I/We authorise any person or company including but not limited to Equifax NZ and other credit agencies to provide you with such information as you may require in response to your credit enquiries, including but not limited to information obtained from the Personal Property Securities Register in respect of the motor vehicle offered as security for this loan .

I/We authorise you to furnish to any third party, including Equifax NZ and other credit agencies, details of this application including Drivers Licence details, which I have voluntarily provided, and any dealings that I/We may have with you as a result of this application being actioned by you.

I/We authorise Falcon Advances Limited to access my/our drivers licence record using the NZTA’s Driver Check service and I/We confirm that the applicant/s will be the sole registered owner/s of the above vehicle.

I/We authorise Falcon Advances Limited to contact Equifax NZ , Credit providers, Finance Companies, my Employer, Landlord, Accountant, Bank, Solicitor or any other source , including Government agencies , to obtain, check & exchange information for the protection & administration of any loan arising out of this application.

To help the government fight the funding of terrorism and money laundering activities, law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.

What this means for you: When you open an account, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver’s licence or other identifying documents.


PERSONAL PROPERTY SECURITIES ACT 1999 VERIFICATION STATEMENT WAIVER

The customer waives/does not waive [Delete one. If no deletion, to be read as “waives”] the need for Falcon Advances Limited to forward a copy of any verification statement in respect of any financing statement or financing change statement registered under the Personal Property Act 1999 “PPSA” by Falcon Advances Limited in connection with any agreement.

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