Finance Application Form
After filling the details click on the SUBMIT button.

* indicates required fields 
  Type of Loan Required:
  *Amount to Finance:
  *Title:
  *First Name:
  Middle Name:
  *Last Name:
  *Date of Birth:
  Drivers Licence Number:
  Licence Expiry Date:
  *Home Phone:
  *Work Phone:
  Mobile:
  *Email:
  *Marital Status:
  *Number of Dependants:
  *Age of Dependants:
  *Residential Address:
  *Town/Suburb:
  *State:
  *Postcode:
  *Time at Address:
  Previous Address (if less than 3 years at current):
  Town/Suburb:
  State:
  Postcode:
  Time at Address:
  *Residential Status:
  *Mortgage/Real Estate/Landlord Name:
  *Location:
  *Contact Number:
  *Your Occupation:
  *Employer Business Name:
  *Employment Status:
  *Employer Address:
  *Town/Suburb:
  *State:
  *Postcode:
  *Time with Employer:
  Previous Employer Name (if less than 3 yrs):
  Employment Status:
  Employer Address:
  Town/Suburb:
  State:
  Postcode:
  Time with Previous Employer:
  *Income:
  *Nett/Gross:
  *Per:
  Other Income (investments/rental properties etc):
  Nett/Gross:
  Per:
  Accountants Details (if self employed):
  Accountant Contact Number:
  *Do you have any Credit Cards?:
  If yes, details of Lender/Limit/Repayments etc:
  *Any other Loans?:
  If yes, details of Lender/Amount/Repayments etc:
  *How much Rent/Mortgage/Board do you pay?:
  *Per:
  *Any other Expenses?:
  If yes, please list:
  Property Value:
  Amount Owing:
  Other Property Value:
  Amount Owing:
  Household Contents Value:
  Investments Value:
  Cash/Savings Value:
  Other:
  *Reference (someone not living with you) Name:
  Address:
  *Contact Number:
  *Have you been previously bankrupt?:
  *Do you have any paid or unpaid defaults?:
  *Do you have any court judgements?:
  If yes for above 3 questions, please give details:
  *Do you agree to a Veda (CRAA) Check?:  Yes
  *How did you hear about us?:

Thank you for taking the time to complete this form.

Alan May Holden and Capital Finance values and respects your rights to privacy of personal information.
To enable Alan May Holden and Capital Finance to assess your application you need to be aware of the following information and provide us your consent to collect and use your personal information.
Without your consent, Alan May Holden and Capital Finance may not be able to consider or approve your application.
Please read our full privacy authorisation form.
 
                                           
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