AUSMARINE FINANCE APPLICATION Please Note: If there are 2 borrowers please fill out and submit form for each borrower
As at 24 Sep 2008
All questions must be answered
Product to be Financed *     Approx. Finance Amount ($) *     TERM * Please Select 24 Months 36 Months 48 Months 60 Months             PERSONAL INFORMATION               Title * Please Select Mr Mrs Miss Ms Dr     First Name *     Middle Name *     Surname *     Email Address *     Home Phone Number *     Mobile Phone Number *     Drivers Licence Number *     Expiry Date *     Date of Birth *     Marital Status * Please select Single Married De-facto Divorced     No. of Children (Dependents only)*             Current Address               Unit/Flat Number *     Street Number *     Street Name *     City/Suburb *     State/Territory * Please Select ACT NSW NT QLD SA TAS VIC WA     Postcode *     Time at Current Address * Yrs Mths     Own/Rent/Buy/Board * Please select Own Home Buying Home Boarding Renting     If Buying/Own Home: Property Value *     If Buying/Own Home: Mortgage Balance *     If Buying/Own Home: Mortgage Provider *     If Renting/Boarding - Landlord's Name     Landlord's Phone Number             Previous Address (if less than 3 years at current address)             Unit/Flat Number     Street Number     Street Name     City/Suburb     State/Territory Please select ACT NSW NT QLD SA TAS VIC WA     Postcode     Time at this address Yrs Mths             Next of Kin               Full Name *     Relationship *     Address (Not at same address as yours) *     Home Phone *             CURRENT EMPLOYMENT DETAILS             Are you Self Employed? * Please select Yes No     If yes, business name *     If yes, please choose one: * Please select Director Sole Trader Subcontractor     Business Address: *     Business Phone: *     Occupation: *     Industry: *     Number of years in business * Yrs Mths     OR       Employer Name *     Employee Status * Please select Full Time Permanent Part Time     Address *     Business Phone *     Business Fax *     Occupation *     Industry *     Number of Years Employed * Yrs Mths             PREVIOUS EMPLOYER (if less than 3 years in current job)             Employer Name     Address     Business Phone     Occupation     Number of Years Employed Yrs Mths             FINANCIAL DETAILS     Income       Gross Annual Income *     Net Monthly Income after Tax *     Other Income (ie, Rental) *     Part Time Income*     Outgoings (Payments)       Mortgage Payment *     Mortgage Provider *     Rent/Boarding *     Car Payment *     Car Loan Provider *     Other Finance *     Other Finance Provider *     If no Current Finance please state your Previous Finances: *             REFERENCES (Not living at the same address)             Reference 1       Please select ONE: Please select PERSONAL BUSINESS     Name *     Address *     Phone Number *             Reference 2       Please select ONE: Please select PERSONAL BUSINESS     Name *     Address *     Phone Number *             Due to spammers hijacking our forms we have been forced to implement the CAPTCHA code. We apologise for the inconvenience.   Enter the code exactly as you see it in the image:- (Cookies must be enabled)
Please make sure you only submit this form once and please be patient as there is a lot of information to process. The next page you will see will be the Privacy Act Disclosure.

Now that you have filled in the above form,  click the 'Submit Form' button above. You will then be redirected to the Declaration Form which you MUST PRINT OUT & SIGN and then FAX it together with a copy of your drivers license to:
AUSMARINE P/L
(02) 9772 4858