Borrower Application

Loan Details

This field is hidden when viewing the form

IP address

This field is hidden when viewing the form

Date

This field is hidden when viewing the form

Branch

Application Type*

Select Application Type. eg Borrower, Guarantor, Company

Name of your partner that has already applied*

Name of borrower you are willing to guarantee*

Name of the company applying for the loan*

Name of the Trust*

Loan amount*

Please enter a number greater than or equal to 400.

Loan payment frequency*

I can afford to repay*

Reason for loan*

e.g buy a car, car repairs, debt consolidation (include car registration plates or trademe ref # of cars to be purchased)

Have you had a loan with us before?*

Yes
No

How did you hear about us?*

Please enter a Promo Code if you have one.

This could get you a special discount.

Declaration

Borrower/Guarantor*

I confirm I have read and understand the Terms and Conditions and I can afford to make the required repayments.

Your Personal Details

Gender*

Male
Female

Title*

First name*

Middle name(s)

Surname or last name*

Other names

e.g. maiden name, married name, former names

Relationship status*

Date of birth*

How many dependents do you support financially?*

e.g. Children that you look after

Contact Details

Email Address*

Mobile phone number*

Identification and Residency

Are you a NZ Citizen or a NZ permanent resident?*

Yes
No

Sorry! You need to be a permanent resident with NZ photo ID. You will not be able to submit this application.

Identification type?*

You need to provide photo identification

Passport Number*

This field is hidden when viewing the form

Card Number

This field is hidden when viewing the form

Card Number

This field is hidden when viewing the form

Passport Number

This field is hidden when viewing the form

Card Number

Licence number 5a*

Licence version 5b*

Please enter a number from 001 to 999.

Licence Type*

Sorry! We need current NZ Photo ID. If your NZ driver’s licence is not current, please apply with your NZ passport or apply again when your driver’s licence is current. You will not be able to submit this application.

Expiry Date*

Do you have a criminal record?*

Yes
No

Details of criminal record*

Have you ever filed no asset procedure (NAP), summary instalment order (SIO) or been bankrupt?*

Yes
No

Details or NAP, SIO or bankruptcy*

Current Address

Road number and name of road/street*

Suburb/RD

Town/city*

This field is hidden when viewing the form

Post code

Accommodation type?*

How long have you lived there?*

Current Employment

Employment status*

Occupation/Benefit type*

Employer*

How long have you been doing this?*

Prior Employment status*

Prior Employer*

How long were you doing this?*

Assets You Own

Please select assets you own or are purchasing?*

Cars, trucks, boats, tractors, trailers etc
Property/land
Business equipment or any high value assets?
I don't own any assets listed above

Select all that apply. Please note we are unable to use chattels or household assets as collateral.

Do you have a partner or guarantor that owns any cars, trucks boats, property etc?*

Yes
No

Name of your partner or guarantor*

Please note your partner or guarantor will need to complete a separate online application as a joint borrower or guarantor.

Sorry! We can not help you with the loan application if you or your partner or guarantor does not own any cars etc or property. Currently we are only providing secured loans and you will be unable to submit this application.

This field is hidden when viewing the form

Do you own any cars, trailers or truck?

Yes
No

Please include all cars you own. Include vehicles financed already.

Make and model*

Year of manufacture*

Registration or number plate*

Is there finance owing on the asset?*

Yes
No

Name of lender*

How much is owing?*

Do you have insurance on the asset?*

Yes
No
TBA

Name of Insurer*

Do you own more cars, trailers or trucks?*

Yes
No

Make and model*

Year of manufacture*

Registration or number plate*

Is there finance owing on the asset?*

Yes
No

Name of lender*

How much is owing?*

Do you have insurance on the asset?*

Yes
No
TBA

Name of Insurer*

This field is hidden when viewing the form

Estimated value of household assets

e.g. Apliances, sporting goods etc.

This field is hidden when viewing the form

Do you have any other assets

Yes
No

This field is hidden when viewing the form

Do you own a house?

Yes
No

Mortgage balance*

Market value of property*

Details of business assets or other high value assets*

Income

Your take-home pay

Please exclude any rent deductions taken from your pay.

Pay cycle

Benefits/other income

Pay cycle

Your partners take-home pay

Your partner must be living with you to include their income.

Pay cycle

Total weekly income (calculated)*

Your total income must be at least $450 per week for your application to be considered.

Expenses

Rent/Mortgage

Payment cycle

Have you had any pay day loans in the last 3 months.

Yes
No

Please be honest as possible to help your application get approved.

Additional Comments

Do you have any other comments or information to help us process your loan?

Who would you like to review your application?

Completion

You are finished! Please click Done.

Finance application

Loan Details

Declaration

Your Personal Details

Contact Details

Identification and Residency

Current Address

Current Employment

Assets You Own

Income

Expenses

Additional Comments

Completion