Employee Finance Application

Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Years at home address
Previous Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Driver Licence Number
Driver Licence Expiry Date
Date Format: DD dash MM dash YYYY
State of Issue
Date of birth
Date Format: DD dash MM dash YYYY

Are you a home owner*
- Yes
- No
Estimated value of home
Amount owing on home
Name of your bank and branch where you have your accounts
Please list all current finance contracts in your name
Please list previous finance if there is no current finance contracts
Name of lender Contract number Asset details Start date Term in years Residual/Balloon payment Monthly payment

Your Work Details
Employer name*
Employer Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Work Phone
Your Work Email Address
Employer Website
Employer Industry
Date started with employer*
Date Format: DD dash MM dash YYYY
Job function and/or title

How would you like this financed?
Type of finance*
How many years would you like the loan for?*
Would you like a residual or lump sum payment at the end of the finance period?*
- Yes
- No

Accountant's details
Company name of accountant
Accountant's name
First Last
Accountant's address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Accountant's phone

Personal financial position
Cash at bank (e.g.: cheque account, savings account, term deposit.)
Current Balance
Superannuation value
Furniture value
Properties
Address In whose name Current estimated value Lender Monthly repayment Balance owing
Vehicles
Vehicle description Current estimated value Lender Monthly repayment Balance owing
Other Assets / Investments
Description Current estimated value Lender Monthly repayment Balance owing
Credit cards
Lender Credit limit Current balance

Your Details

Name of lender	Contract number	Asset details	Start date	Term in years	Residual/Balloon payment	Monthly payment

Current Balance

Address	In whose name	Current estimated value	Lender	Monthly repayment	Balance owing

Vehicle description	Current estimated value	Lender	Monthly repayment	Balance owing