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Please complete the following application form to apply for finance through Town & Country Motors.
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2017 Mazda BT-50 GLX D/C 2WD
180,800km, Automatic, Diesel, 3200cc $22,995

1. Applicant Information

Please enter your first name(s)
Please enter your last name
Please enter your date of birth (dd/mm/yyyy)
Please enter your marital status
Please enter a valid email address
Please enter drivers licence no
Please enter drivers licence version no
Please enter a your address
Please enter suburb
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Please enter a your postcode
Please enter the years lived at the above address
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

2. Finance Details

Please enter the amount you wish to finance
.00
Please describe the vehicle you wish to finance

Before completing this application it is a requirement that you read and accept the below Privacy Act Statement.

3. The Privacy Act 2020

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

I/we authorise Town & Country 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 Town & Country Motors to provide this information:

  • To any person for the foregoing purposes;
  • to any employees and agents of Town & Country 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 Town & Country Motors about me/us and to request that this information be corrected. The information will be held at the office of Town & Country Motors, Christchurch or the registered offices of any party nominated by Town & Country Motors.

*Town & Country 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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