Application

	I authorise permission for Verus Finance to undertake their privacy conditions

Loan Amount Required
Purpose of Loan	Car Finance Personal Loan Debt Consolidation Other
Other Purpose
Security *
* Must be owned by the applicant/s or co borrower.
Reg. No. of Vehicle or Property Address
Total value of all mortages secured against property (if applicable)

MAIN BORROWER
Title
First Middle Names
Surname
Date of Birth
Phone Home
Phone Work
Phone Mobile
Email Address

CO BORROWER (if applicable)
Title
First Middle Names
Surname
Date of Birth
Phone Home
Phone Work
Phone Mobile
EMail Address

Best time and number to call you on
NZ Resident?	Yes No
(if no Verus Finance will require a co-borrower who is a permanent resident)

Current Address
Address Status	Rent Board Own Home
Length of time at this address
Previous Address (if less than 2 years at current address)
Current Occupation
Current Employer
Previous Employer (If less than 2 years with current employer)
Average Net Income (after tax)
Pay Period	Weekly Fortnightly Monthly
Comments/Questions
Where did you hear about Verus Finance?	Internet Search Word of Mouth Previous Verus Finance Customer Newspaper or other advertising