Kawasaki Finance at Whitehouse Motorcycles Albury Wodonga

Tips for completing this form:

Please give us as much information as possible to support your application.
The fields marked with an asterisk (*) are mandatory.

Applicant Information

Title(*)

Please enter your title.

First Name(*)

Please enter your first name.

Last Name(*)

Please enter your last name.

E-mail(*)

Please enter your email address.

Phone(*)

Please enter your phone number, not including +61.

Gender(*)

Please enter your gender.

Date of Birth

Invalid Input

Number of Dependants*(*)

Please enter the number of dependants.

Drivers License Number(*)

Please enter your drivers license number

Drivers License Issued By(*)

Please enter the state drivers license was issued by

Drivers License Expiry Date

Invalid Input

Permanent Resident(*)

YesNo Please enter if you are a permanent resident

Current Address

Street Address (PO Boxes no accepted)

Invalid Input

City

Invalid Input

State

Invalid Input

Postcode

Invalid Input

Country

Invalid Input

Residential Status

OwnedRentingBoarding Invalid Input

Years in Residence

Invalid Input

Months in Residence

Invalid Input

Previous Address (If less than 3 years at current address)

Street Address (PO Boxes no accepted)

Invalid Input

City

Invalid Input

State

Invalid Input

Postcode

Invalid Input

Country

Invalid Input

Residential Status

OwnedRentingBoarding Invalid Input

Years in Residence

Invalid Input

Months in Residence

Invalid Input

Employment Information

Current Employer Name

Invalid Input

Occupation

Invalid Input

Employer Phone Number

Invalid Input

Employer Contact Name

Invalid Input

Years Employed

Invalid Input

Months Employed

Invalid Input

Monthly Income After Tax

Invalid Input

Previous Employment (If less than 3 years at current employer)

Previous Employer Name

Invalid Input

Occupation

Invalid Input

Employer Phone Number

Invalid Input

Employer Contact Name

Invalid Input

Years Employed

Invalid Input

Months Employed

Invalid Input

Expenses

Mortgage Financier

Invalid Input

Mortgage Account Balance

Invalid Input

Mortgage Monthly Repayments

Invalid Input

Monthly Living Expenses (Not including Mortgage/Rent or other loan repayments)

Invalid Input

Other Loan 1 (if applicable)

Type of Loan or Credit

Invalid Input

Financier

Invalid Input

Monthly Amount

Invalid Input

Other Loan 2 (if applicable)

Type of Loan or Credit

Invalid Input

Financier

Invalid Input

Monthly Amount

Invalid Input

Other Loan 3 (if applicable)

Type of Loan or Credit

Invalid Input

Financier

Invalid Input

Monthly Amount

Invalid Input

Credit Card 1 (if applicable)

Type

Invalid Input

Card Issuer

Invalid Input

Credit Card Limit

Invalid Input

Credit Card 2 (if applicable)

Type

Invalid Input

Card Issuer

Invalid Input

Credit Card Limit

Invalid Input

Credit Card 3 (if applicable)

Type

Invalid Input

Card Issuer

Invalid Input

Credit Card Limit

Invalid Input

Asset to be Financed

Condition

Invalid Input

Manufacturer

Invalid Input

Model

Invalid Input

Year

Invalid Input

Purchase Price

Invalid Input

Deposit / Trade in Value

Invalid Input

Balance to be Financed

Invalid Input

Term

Invalid Input

Frequency

Invalid Input

Next of Kin (Not living at same address)

First Name

Invalid Input

Last Name

Invalid Input

Address

Invalid Input

Contact Number

Invalid Input

Relation to Primary Applicant

Invalid Input

reCAPTCHA(*)

Invalid Input