APPLICATION FOR CREDIT

1. 2. 3. 4. 5. 6. 7. Applicant:
Surname Christian Names

Marital Status: Spouses Name:

Surname

Number of Dependants:

Christian Names

Date of Birth:
Applicant Spouse

Drivers Licence No: Email Address:

Applicant

Spouse:

/
Spouse

Current Address: Years:

8. 9.

Tenancy (PLEASE CIRCLE): Own House / Renting / Boarding / Family House / Other (Detail): Previous Address: )
(Private)

Years: ( )
(Business)

10. Phone No: (

)
(Mobile)

11. Present Employer: ___________________________________________________________________________ Years: Address: ______________________________________________________ Occupation:

12. Previous Employer:___________________________________________________________________________ Years: 13. Spouses Employer: __________________________________________________________________________ Years: Address: 14. Parents Name/Nearest Relative: Address: _______________________________________________________ 15. Account References:
(Hire Purchase/Credit Card, etc)

Occupation:

Relationship: (2)

(1) Account No:

16. Bankers:

AS S E TS (please note all assets which are jointly owned)

Home (joint/JFH) Furnishings Bank Car Investments Other TOTAL $ $ $ $ $ $ $

LI AB I L I TIE S
Mortgages HP/credit accounts Bank O/D Other creditors, loans TOTAL $ $ $ $ $

NET WORTH EXPE NSES (monthly)

Mortgages/rent payments HP and credit accounts Rates, phone, power, insurance Life insurance/building society Car and other expenses TOTAL

I N C O M E (monthly)
Average take home pay $ Spouses take home pay $ Other income TOTAL $ $

$ $ $ $ $ $

Privacy Act 1993 I/We: (a) warrant that the information provided in this application is true and correct; (b) authorise BMW Financial Services New Zealand Limited (BMW Finance) to contact my/our employer, any credit agency and any other source (each a Source) to obtain, check and exchange (both now and in the future) information in connection with this application and any agreement that I/we may hereafter enter into with BMW Finance; (c) acknowledge that my/our signature on this application shall operate as an authority to each Source to provide BMW Finance with any information about me/us which BMW Finance may require in connection with this application or any such agreement; (d) acknowledge that this application will form part of any agreement I/we may hereafter enter into with BMW Finance and that the authorisation set out above will be deemed to be incorporated into that agreement. (e) authorise BMW Finance, BMW New Zealand Limited and any related BMW Group company to store and process the information provided in this application to contact you with product information, event invitations and/or customer care related material. You are entitled, under the provisions of the Privacy Act 1993, to: (a) have access to personal information held by BMW Finance about you; and (b) request correction of any personal information held by BMW Finance about you; in either case in accordance with the provisions of that Act.

Signed:
SIGNATURE

SIGNATURE

Dated:

/
DATE