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Title * —Please choose an option—MrMrsMsMiss
First Name *
Middle Name
Last Name *
Date of Birth *
Marital Status * —Please choose an option—SingleMarriedDe Facto
Number of Children under 18 * —Please choose an option—012345678910+
Are you a New Zealand Citizen? * —Please choose an option—NZ CitizenPermanent ResidentWork Visa
Drivers Licence Type * —Please choose an option—Learners LicenceRestricted LicenceFull LicenceOverseas Licence
Drivers Licence No.*
Version No. *
Home Phone
Mobile Phone *
Email Address *
House Type * —Please choose an option—Own HomeRentingBoardingLiving With Parents
Home Address *
Suburb *
City
Time Lived at Address
How much is your mortgage/rent? *
How often is this payment * —Please choose an option—WeeklyFortnightlyMonthly
How do you pay this —Please choose an option—Bank TransferCashWINZ Redirection
Previous Address *
Employment Type * —Please choose an option—Full TimePart TimeCasualSeasonalBeneficiaryRetired
Company Name *
Occupation *
Time at Employer
Amount (in the hand) *
Pay Frequency * —Please choose an option—WeeklyFortnightlyMonthlyOther
How do you receive this money? —Please choose an option—CashBank TransferWINZ/IRD
Other Income
Other Income Source
Vehicle Description
How did you hear about us ? —Please choose an option—GoogleFacebookReferralOther
I/we authorise Gowaka* 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 Gowaka’s rights thereunder; Marketing and/or informing me/us about the goods and services provided by Gowaka I/we authorise Gowaka 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 Gowaka to provide this information:
To any person for the foregoing purposes; to any employees and agents of Gowaka 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 Gowaka about me/us and to request that this information be corrected. The information will be held at the office of Gowaka, 82 Great South Road, Papatoetoe, Auckland or the registered offices of any party nominated by Gowaka.
*Gowaka and other associated third parties
To verify your acceptance of the above Privacy act statement please tick the checkbox below and click the Apply for Finance button.
I Accept all The Terms and Conditions
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