Transcription of Statement of Financial Position
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Statement of Financial Position
Statement of Financial Position Assets and Liabilities (For use where further information is required and for credit limit increases). Please complete this application form in BLOCK letters and return: Assets Value Liabilities Limit Balance Monthly payments By mail to Gem, PO Box 4058, Shortland Street, Auckland 1140. By fax to 0800 504 300. Residence/property/land $ Household mortgage/rent/board $ $. Personal Details Credit cards; Account/Application Number Visa/Mastercard/bankcard/store/retail/. Motor vehicles $ $ $ $. hire purchase/charge card/. Amex card/Diners Club/other Title First Name Other (specify); home contents/ Personal loans/vehicle loans/leases $ $. Mr Mrs Ms Miss Dr cheque/savings account/investments $. (shares/bonds)/boats/caravans Bank overdraft $ $ $. Last Name Date of Birth Total Assets $ Total Liabilities $ $. D D M M Y Y Y Y. Marital Status Married Defacto Single Widowed Number of Dependants Personal Referee Details (only complete if not previously provided in the last month).
Statement of Financial Position (For use where further information is required and for credit limit increases) Gem Visa is provided by Latitude Financial Services Limited.
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