125 - 127 Gracefield Road, Lower Hutt
Ph. 04 566 6484 04 566 6484

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Please complete the following application form to apply for finance through Trade In Clearance.
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2004 Ford Falcon BA XR8 4A
248,816km, Automatic, Petrol, 5408cc $15,995
Note: Clean Car fee/rebate may also apply

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 your name on driver's licence
Please enter drivers licence no
Please enter drivers licence version no
Please enter your drivers licence type
Please enter your drivers licence expiry date
Please enter a valid email address
Please enter a mobile phone
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
Please enter the amount in the hand
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Please enter your pay frequency
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2. Finance Details

Please enter preferred repayment amount
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3. Contact Details

Next of Kin Details (NB - Must not live at the same address as you)
Please enter the name
Please enter the relationship (eg mother/father etc)
Please enter the contact number
Please enter a the address
Please enter the suburb
Please enter the city

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

Privacy Statement

The Purchaser irrevocably authorises and consents to MVT or any financier, credit reporting agency or any other person or entity required for the purpose of completing this contract requesting, obtaining and retaining any personal information about the Purchaser from any individual, company, state owned enterprise or government department in the public or private sector and the Purchaser irrevocably authorises and consents to any individual, company, state owned enterprise or government department in the public or private sector providing the MVT with such personal information about the Purchaser as requested by MVT.

The Purchaser irrevocably authorises and consents to MVT or any financier, credit reporting agency or any other person or entity required for the purpose of completing this contract providing any personal information held by MVT about the Purchaser to any individual, company, state owned enterprise or government department in the public or private sector.

You authorise the MVT (either directly, via service providers of the MVT, or otherwise) to collect information about you and your interactions with the MVT (including but not limited to your name, contact details, your credit history and payment details, your communication preferences, via methods including but not limited to direct feedback, surveys and social media). This information will be collected, held and used by the MVT and/or service providers of the MVT, and/or it may be disclosed to third parties, for the purpose of:

(a) communicating with you (by telephone, post, email, text or otherwise) in relation to this sale and to seek your feedback on our services;
(b) cooperating with Government, regulatory or industry authorities;
(c) providing you with items on this agreement and any other products or services that you may receive from us, including by sharing information with providers of these products or services;
(d) running and administering promotions and competitions;
(e) marketing and promoting our and/or third party products and services to you.

You acknowledge and agree that such information may be held and used by the MVT and/or service providers of the MVT both before and after termination of this contract, but only in the manners permitted by law.

You acknowledge that, pursuant to the Privacy Act 2020, you have a right to request access to the information collected about you by MVT, or any party nominated by MVT, and also to request that this information be corrected if required. The information will be held at the office of MVT and/or the registered offices of any party nominated by MVT.

Please note: Should you wish to have your name and address made private, you may contact the NZTA and request this be done.

To verify your acceptance of the above Privacy Statement please enter the word ACCEPT into the text box below and click the submit button.

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