Online Finance Application

To Apply for Finance online, please fill in the following fields and submit to Southwest Spas

Finance Option - Interest bearing account over 60 months, interest 19% PA, mininmn deposit required $500 - balance over 60 months

Customer Information

PLEASE FILL IN ALL BOXES

Name

Last Name

Street Address

City / Town

Country

Years Months

Post Code

Time at Address

Home Phone

Work Phone

Email Address

Residential Status

Finance Details

Finance Option 1 or 2

Deposit to Pay in $

Amount on Finance

Gender

Male Female

Date of Birth


Date	Month	Year

Marital Status

Number of Dependants

Driver's licence Number

Employment Details

Employment Status

Occupation

Employers Details

Name

Telephone

Suburb/City

Time with Current Employer
	Years Months

Time with previous employer
	Years Months

Do you have a second job?	Yes No

Income Details
Net monthly income

Additional monthly income

Expense Details
Monthly household living expenses

Monthly rent/mortgage payment

Liability Details
Please list all your liabilities.
Liability 1
Liability type

Credit limit or amount borrowed

Original loan term (if applicable)

Bank or financial institution name

Monthly payment

Current balance

Asset Details
Home Building
Value
Insured	Yes No
Home Contents
Value
Insured	Yes No
Other Assets
Value
Insured	Yes No

ONCE THIS APPLICATION IS FILLED IN, WE WILL CONTACT YOU AND GO THROUGH THIS APPLICATION WITH YOU.

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