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Online Application
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Please complete the following form in full and click submit to apply for Smartcover Finance.
A credit check will be carried out as part of the Application process. Please ensure all details you enter are accurate to enable us to correctly assess your application - as quickly as possible. Any inaccurate information could result in delays processing your application.
We will be in contact with you soon after to advise if your application has been successful or if we require any further information.
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Fields marked with * required
Application Details:
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Applicant Details
Title:
Mr
Mrs
Miss
Ms
First Name:
Last Name:
DOB (DD-MM-YYYY):
Email Address:
Drivers Licence #:
Drivers Licence Version #:
Best Contact Number:
Other Contact Number:
Street Address:
Suburb:
Town:
Next of Kin (not living with you):
Next of Kin Phone:
Next of Kin Address:
Next of Kin Relationship:
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Joint Applicant Details (Only If Applicable)
Title:
Mr
Mrs
Miss
Ms
First Name:
Last Name:
DOB (DD-MM-YYYY):
Contact Phone Number:
Relationship to First Applicant:
:
Monthly Expenses
Rent/Mortgage Payments:
Loans/Hire Purchase:
Bill Payments:
Other Expenses:
Totals:
:
Vehicle Details
Vehicle Make:
Vehicle Model:
Vehicle Year:
Vehicle Rego:
Registered Owner:
Vehicle Colour:
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Employment Details
Type:
Full Time
Part Time
Self Employed
Student
Beneficiary
Pensioner
Other
Position:
Employer:
Telephone:
Time Employed:
NET Income After Tax* (total if 2 applicants):
Frequency:
Weekly
Fortnightly
Monthly
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Loan Repayment Details
Preferred Week Day:
Monday
Tuesday
Wednesday
Thursday
Friday
Payment Frequency:
Weekly
Fortnightly
Monthly
Next Income Payday:
Please tell us why you require finance (store name, location, contact person etc and $ amount required. "N/A" if unsure):
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The Privacy Act 1993:
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I/we authorise Smartcover* to collect, retain and use the personal information about me/us, for the purposes of: • Assessing my/our credit worthiness; • Attending to the financing, whether directly or indirectly, of my/our contract(s) and enforcing Smartcovers rights thereunder; • Marketing and/or informing me/us about the goods and services provided by Smartcover I/we authorise Smartcover to collect from credit reporting agencies, credit providers, my/our employer(s), accountant(s), relatives, or other person(s) such personal, financial and commercial information about me/us for the said purposes. I/we authorise Smartcover to provide this information: • To any person for the foregoing purposes; • To any employees and agents of Smartcover and/or any other person, in any ordinary course of business, for any of the foregoing purposes; • To credit agencies for the purpose of maintaining proper or effective records. I/we acknowledge that if I/we do not provide all or any part of the information requested on this application form, my/our application for finance may be declined. I/we further acknowledge that pursuant to the Privacy Act 1993, I/we have a right of access to information collected by Smartcover about me/us and to request that this information be corrected. The information will be held at the office of Smartcover Finance Limited, 3-2E Ceres Court, Albany, Auckland or the registered offices of any party nominated by Smartcover Finance Limited. * Smartcover Finance Limited and other associated third parties.
Privacy Act Acceptance:
I accept the terms and conditions as set out above.
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Address
3-2E Ceres Court
Rosedale
Auckland 0632