Please answer all of the fields so that we can provide a prompt approval

First Borrower

Title Mr Mrs Miss Ms

First Name

Middle Name

Last Name

Preferred Name

Address

City

Date of Birth (dd/mm/yyyy)

Marital Status Please choose Married Single De-facto Civil Union

Number of Dependants

Time at Current Address Years Months

Previous Address

 

Previous City

Time at Previous Address Years Months

Home Phone Number

Mobile Number

Email Address

Please re-enter Email Address

Drivers Licence Type Please choose Full Restricted Learner None

Residency Status Please choose NZ Citizen NZ Resident Work Permit Other

Residential Status Please choose Renting Mortgage Boarding Freehold Living with Parent

Mortgage / Rent Amount (Monthly) $

Take Home Pay $

Take Home Pay Frequency Monthly Weekly Fortnightly Varies

Other Income (monthly) $

Type of other income (i.e dividends)

Are you Self Employed? Yes   No

What is your Occupation?

Occupation Type? Please choose Full time Part time Casual Seasonal Contractor

Current Employer

Employer Phone Number

Time at Current Job Years Months

Previous Occupation

Previous Employer

Previous Employer Phone Number

Time at Previous Job Years Months

Is this a Joint Application? Yes   No

Do you own your home? Yes   No

House Hold Contents Value $

Do you have a Guarantor? Yes   No

Other Assets Value $

Other Assets Description

Other Assets Value 2 $

Other Assets Description 2

Please tell us about all the Loans, HP’s, Store and Credit Cards etc that you have in your name or that you are making payments for. This will assist us to determine your affordability and maximum lend. It’s important that you declare all of them for a prompt approval.

Please list all unsecured term loans that you may have.
i.e. bank loans, cash loans etc

Please list all credit cards and store cards that you may have

Please list all secured loans that you may have such as retail hire purchase agreements or car loans

Please list any other loans or debts that you may have

Please provide us with two alternate contacts being friends or family not living at the same address. We will not contact these people as part of this application and will only contact them in the event of default.

Name of family member

Their current residential address

City

Their home phone number

Your relationship with them

Name of friend

Their current residential address

City

Their home phone number

Your relationship with them

How did you hear about us? Please choose TV Radio Search Engine Word of Mouth Facebook Signs Previous Customer Another Finance Company Banner Ad

Referral Code (If any)

Preferred method of contact Please choose Phone Email

Can we contact you at work?

Any additional information to support your application

Help us stop SPAM. Type in this number:

Thank you for completing the loan application form. Please submit.