Yamaha Motor Finance
         
  Applicant Details  
     
1 Applicant One
 
2 Applicant Two
First Name:
 * 
First Name:
Middle Name:
 
Middle Name:
Last Name:
 * 
Last Name:
Date of Birth:
 
Date of Birth:
Drivers Licence:
 
Drivers Licence:
 
Licence Version:
 
Licence Version:
Living Status:
 
Living Status:
Marital Status:
 Dependants:  
Marital Status:
 Dependants:
Current Address:
 
Current Address:
City:
 
City:
Time at Address:
 Months   Years  
Time at Address:
Months   Years
Home Phone:
 
Home Phone:
Fax Number:
 
Fax Number:
Work Phone:
 
Work Phone:
Mobile Phone:
 
Mobile Phone:
Email Address:
 * 
Email Address:
         
  Employment Details  
     
3 Employment: Applicant One
 
4 Employment: Applicant Two
Occupation:
 
Occupation:
Time at Occupation :
 Months   Years  
Time at Occupation :
 Months   Years
Employer:
 
Employer:
Address:
 
Address:
City:
 
City:
Phone Number:
 
Phone Number:
Mobile Phone:
 
Mobile Phone:
Prev Occupation:
 
Prev Occupation:
Time at Occupation:
Months   Years  
Time at Occupation:
Months   Years
Prev Employer:
 
Prev Employer:
         
  Vehicle Details  
     
5 Purchase Vehicle Details
 
6 Trade-In Vehicle Details
Make:
 
Make:
Model:
 
Model:
Year:
 
Year:
Stock No#:
 
Mileage:
     
Rego No#:
         
  Loan Details  
     
7 Loan Details
   
Vehicle Price:
     
Cash Deposit:
     
Less Trade-In:
     
Amount Required:
     
         
  Accounting Details  
     
8 Assets
 
9 Liabilities
Home:
 
Mortgages:
Furnishings:
 
HP/Credit Accounts:
Bank:
 
Bank O/D:
Vehicle:
 
Other Creditors:
Investments:
 
Other Loans:
Other:
 
Total Liabilities:
Total Assets:
 
Net_Worth:
         
10 Income Total Monthly
 
11 Expenses Total Monthly
Take Home Pay:
 
Rent:
Other Income:
 
Mortgage Payments:
Total Income:
 
HP/Credit Accounts:
     
Phone, Power, etc:
     
Insurance:
     
Car & Other:
     
Total Expenses:
         
  Terms  
     

I apply for a loan and certify that the particulars above and overleaf are true and correct and that I am over the age of 18 years and am not an undischarged bankrupt. Pursuant to the Privacy Act 1993 I authorise any finance company to contact any credit reporting agencies, credit providers, my employer(s), accountant(s), or any other source, to obtain, check and exchange (both now and in the future) such personal, financial and commercial information and references about me/us as is necessary for the purposes of considering this application, the protection and administration of any loan arising out of this application, and to assist in the enforcement of any agreement between me/us and any finance company. I agree that you may produce this authority to such parties for the purposes of collecting such information. Under the provisions of the Privacy Act 1993, you are entitled to have access and request correction to personal information held about you.

I agree that the information in connection with this with this finance application may be transmitted via facsimile and/or electronic mail, and I acknowledge that there may be some security risks associated with the transmission.

I have read and accept the terms and conditions within this informative statement/authorisation. Please ensure the details you have provided above are correct before submitting the application.