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Gilrose Finance Application

Hi!

Thanks for considering making an online application. To get pre-approval for Finance please fill out the form below as much as you can. It takes only 5 minutes and an answer will be returned within almost an hour (during business hours). If there’s any questions you're unsure of, or to query your application process, please feel free to give one of our friendly sales centre staff a call on 0800 2 GET FIT.

We use Gilrose Finance as our first choice for lending.

PRODUCT INFORMATION
Product:
If other, please give a description of goods*
Value of Goods *
Deposit *
Term (Months) *
Payment Frequency *
PURCHASER INFORMATION
Given Name *
Middle Names
Surname *
Proof of Identity *
ID No *
Date of Birth *
Vehicle Registration No
CUSTOMER INFORMATION
PHYSICAL ADDRESS
Street Address *
Suburb *
Town / City *
Since how long at above address *
PREVIOUS ADDRESS (if less than 3 years at above address)
Full Address
For how long at above address
POSTAL ADDRESS (if different than physical address)
Street Address
Suburb
Town / City
Post code
CONTACT DATAILS
Home Telephone No. *
Is the number above listed in your name?* yesno
Mobile Phone No.
Email
EMPLOYMENT
Employment Status *
Occupation
Work Phone No.
Employers Name
Since how long?
Position
Previous Employers Name
Previous Employers Phone No.
How long at Job?
NEXT OF KIN ADDRESS (not living with you)
Next of Kin Name *
Next of Kin Address *
Next of Kin Phone No. *
GENERAL
Marital Status *
Name of the Partner
Number of Dependants
Personal Weekly Income (Before Tax - Applicant Only) *
If Other (Specify)
Do you have content insurance?
Insurance Company Name
Home Owner*yesno
Value of Home (Approx)
Balance of Mortgage(Approx)
CREDIT REFERENCE- LOANS OUTSTANDING : ($ Approximations Only)
Name of Company :
Original Balance:
Balance Owing:
Monthly Payments:
Name of Company :
Original Balance:
Balance Owing:
Monthly Payments:
Name of Company :
Original Balance:
Balance Owing:
Monthly Payments:
Name of Company :
Original Balance:
Balance Owing:
Monthly Payments:
PRIVACY ACT
Credit Reporting Privacy Code 2004

I hereby authorise any person or company to provide you or Gilrose Finance Co Limited with such information as you may require in response to your enquiries associated with this application. I also further authorise you to furnish to any third party or parties details of this application and any subsequent dealings that I may have with you as a result of this application being actioned by you. I hereby declare that the information provided is true and correct and that I am not an undischarged bankrupt. I agree that the financier may nominate the insurer at its discretion. I understand that Gilrose Finance Company Ltd have asked me for personal information about me so as to use Veda Advantage's credit reporting service to credit check me. I understand that:

Veda Advantage will give you information about me for that purpose. You will give my personal information to Veda Advantage, and that Veda Advantage will hold that information on their systems and use it to provide their credit reporting service. When other Veda Advantage customers use the Veda Advantage credit reporting service, Veda Advantage may give the information to those customers. If I default in my payment obligations to you, information about that default may be given to Veda Advantage, and Veda Advantage may give information about my default to other Veda Advantage customers.
ACCEPTED
Applicant First Name *
Applicant Surname *