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First name
*
Last name
*
Date of birth
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Year
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1925
Year
Your marital status
*
Single
Married
Divorced
Defacto
Separated
Widowed
Dependents
*
0
1
2
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5 or more
Mobile
*
Email
*
Residency status
*
New Zealand Permanent Resident
New Zealand Citizen
Work permit
Employment status
*
Full time
Part time
Causal
Seasonal
Beneficiary
Retired
Student
Self Employed
Unemployed
Driving license type
*
New Zealand Full License
New Zealand Restricted
New Zealand Learner
Overseas
No license
License number
*
License version
*
Current address
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Document category
Driver license
Passport
Pay slip
Bank statement
Address proof
Other
Document category
I/we authorise Easy motors 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 Easy motors’s rights under;Marketing and/or informing me/us about the goods and services provided by Easy motors
I/we authorise Easy motors 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 Easy motors to provide this information:
To any person for the foregoing purposes; To any employees and agents of Easy motors 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 Easy motors about me/us and to request that this information be corrected. The information will be held at the office of Easy motors, Easy motors or the registered offices of any party nominated by Easy motors.
* Easy motors and other associated third parties
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