Application Form Apply for car loan financing online by filling in your details below. We’ll endeavour to get back to you within 24 hours of your application with further instructions. Name First Last Date of Birth GenderMaleFemalePhoneEmail Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Years at this address?Residential StatusRentBoardMortgageHousing New ZealandOtherType of LicenceForeign LicenceLearnersRestrictedFullLicence Number (5a)Version Number (5b)Privacy Waiver Pursuant to the Privacy Act 1993, I/we hereby acknowledge and give approval for Dolbak Finance to collect personal information about me/us in order to assess the eligibility to open a credit account. The information may be collected from any third party including, but not limited to, Credit Agencies and Government Departments. The information is being collected and will be held by Dolbak Finance Ltd and may be shared with Government Agencies and Credit Companies. You have rights of access to, and correcting of this information, subject to the provisions of the Privacy Act 1993. I / We authorise the disclosure of personal information held by any party with respect to this agreement and to also to releasing to other parties personal information regarding this agreement. By submitting an application I confirm that all information provided is accurate, up-to-date, complete, relevant, not misleading and that I am not an undischarged bankrupt. I understand and agree to the terms and conditions, and that I will be contacted by phone or email from one of Dolbak Finance’s business representatives. Agree to the Terms and Conditions* I Agree Please note the provision of providing your driver license information for the above checks is voluntary. CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Not sure how to navigate bad credit car finance? Complete the form and we will see what we can do for you. Take the stress out of buying a car by making the most of our loaning and financing options. Phone: 09 580 1000 Email: dolbak@callplus.net.nz Address: 49 O'Rorke Road, Penrose, Auckland, 1061 Set an Appointment
