Telephone: 04 589 6289 04 589 6289
355 High Street, Lower Hutt

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Please complete the following application form to apply for finance through Value Motors.
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2009 Dodge CHALLENGER R/T....JUST 35,969KMS!!
35,969km, Automatic, Petrol, 5700cc $59,995
No rebate or fee
Applicant
1
Address & Employment
2
Contact
3
Financials
4
Loan Detail
5
Apply
6

1. Applicant Information

Is this a joint application? No
Please enter your first name(s)
Please enter your middle name(s)
Please enter your last name
Please enter your marital status
Please enter the number of dependants
Please enter your drivers licence type
Please enter drivers licence no
Please enter drivers licence version no
Please enter a valid email address
Previous Finance Details

2. Address & Employment

Address Details
Own House
Renting
Boarding
Other
Please enter a Tenancy Type
Please enter a your address
Please enter suburb
Please enter city
Please enter the years lived at the above address
Employment Details
Please enter your employment start month
Please enter your employment start year
Please enter your occupation
Please enter your employer
Please enter hours worked per week
Please enter a your previous address
Please enter suburb
Please enter city
Please enter your employers phone number
Please enter your employment start month
Please enter your employment start year
Please enter your occupation
Please enter your employer
Please enter hours worked per week
Please enter a your previous address
Please enter suburb
Please enter city
Please enter your employers phone number

3. Contact Details

Next of Kin Details (NB - Must not live at the same address as you)
Please enter the name
Please enter the relationship (eg mother/father etc)
Please enter the contact number
Please enter a the address
Please enter the suburb
Please enter the city
Another Contact's Details (eg. Friend, Workmate etc)
Please enter the name
Please enter the relationship (eg mother/father etc)
Please enter the contact number
Please enter a the address
Please enter the suburb
Please enter the city

4. Financials

Income
Applicant 1
Please enter your income type
Please enter the amount in the hand
.00
Please enter your pay frequency
Applicant 2 / Partner Income
.00
Assets
Property 1
.00
.00
.00
Is Rental?
Property 2
.00
.00
.00
Is Rental?
Vehicle 1
.00
.00
.00
Vehicle 2
.00
.00
.00
Other Assets
.00
.00
.00
.00
Outgoings (IE. Your expenses and repayments)
Expenses
.00
.00
.00
.00
Loan Repayments
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00

5. Loan Details

2009 Dodge CHALLENGER R/T....JUST 35,969KMS!!
35,969km, Automatic, Petrol, 5700cc $59,995
No rebate or fee
.00
Please enter the amount you wish to finance
.00
.00
Please describe the vehicle you wish to finance
Please select your preferred payment term
.00
Please enter your preferred repayment amount
Please enter your preferred repayment frequency
Other Information
Do you have any previous credit related issues that may need to be addressed prior to a successful application?
No
Are you an NZ citizen/NZ born?
Yes
I am also interested in
purchasing Mechanical Breakdown Insurance for this vehicle

The Privacy Act 2020

I/we authorise Value 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 Value Motors’s rights thereunder;
  • Marketing and/or informing me/us about the goods and services provided by Value Motors

I/we authorise Value 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 Value Motors to provide this information:

  • To any person for the foregoing purposes;
  • to any employees and agents of Value 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 2020, I/we have a right of access to information collected by Value Motors about me/us and to request that this information be corrected. The information will be held at the office of Value Motors, 355 High Street, Lower Hutt or the registered offices of any party nominated by Value Motors.

*Value Motors and other associated third parties

To verify your acceptance of the above Privacy act statement please enter the word ACCEPT into the text box below and click the submit button.

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