Title:

Mr Mrs Dr Miss

How Did You Hear About Us:

Facebook Instagram Gumtree Word of Mouth

Marital Status:

Defacto Single Married Divorced Separated

Number of Dependants: *

Occupancy:

Own Renting Boarding

Rent Frequency:

Weekly Fortnightly Monthly Yearly

Weekly income after tax:

Employer Company Name:

Time at previous job:

Best time to call you: *

Before work hours During work hours After work hours Weekend Anytime

Are you currently bankrupt?

YES NO

Are you currently subject to a Part 9 agreement?

YES NO

How much would you like to borrow:

$10,000 $10,000–$20,000 over $20,000

Which of the following best describes your needs and objectives (select one or more options)?

To own a motor vehicle To transport my family around For business use To get to and from work

I'll add my own needs/objectives in the comments box below.

Needs Objectives / Comments:

Are you applying for a loan at fixed repayments or a business loan?

Fixed Repayments Business Loan

Are there any other loan features that are important or any other needs required?

NO YES

If answered YES please explain:

We are required by law to make reasonable inquiries about your financial situation, requirements and objectives and we must also take steps to verify the information provided. We may also need to make further inquiries to ensure that a credit contract is "not unsuitable" for you.

Smart Choice Cars Pty Ltd t/as CrediCars accepts no liability for any recommendation made on the basis of inaccurate or incomplete information.

Have you understood what you have just read?

NO YES

I accept all the terms and conditions*

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Application Form