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     About the loan

What is your loan for? *
How much would you like to borrow?
Deposit
Loan amount
$ 0.00

     About you

Title *
First name *
Middle name
Last name *
Date of birth *
Marital status *
Mobile number *
Email address *
Number of dependants *

Accept Terms *

I have read and agree to the Terms and Conditions and Privacy Policy provided.


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     Driver's licence details

Driver's licence type *
Driver's licence number *
Driver's licence expiry *
Version number *

     Address details

Living situation *
Current address *
Years at address *
Mortgage or rent payments *
Frequency of payments *

     Employment details

Employment type *
Occupation *
Employer
Name of business *
Years worked
Income after tax *
Frequency of income received *

     Assets

Do you own a home?
Yes
No
Home value

Do you own any boats?
Yes
No
Boat value
Do you own any vehicles?
Yes
No
Vehicle value

Do you have any other assets?
Yes
No
Others assets value

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     Liabilities

Do you have any home loans?
Yes
No
Amount owing on homes
Monthly repayments on home loans

Do you have any boat loans?
Yes
No
Amount owing on boats
Monthly repayments on boat loans

Do you have any hire purchases?
Yes
No
Amount owing on hire purchases
Monthly repayments on hire purchases

Do have any other debts?
Yes
No
Amount owing on other debts
Monthly repayments other debts

Do you have any vehicles loans?
Yes
No
Amount owing on vehicles
Monthly repayments on vehicle loans

Do you have any personal loans?
Yes
No
Amount owing on personal loans
Monthly repayments on personal loans

Do you have any credit cards?
Yes
No
Amount owing on credit cards
Monthly repayments on credit cards

Additional notes Any additional information that will help us assess your application.

Declaration *

I confirm that all information that I provide is current, complete and accurate and I am not aware of any foreseeable changes in my circumstances that will impact on my ability to make the contracted repayments over the life of the loan contract.

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24 Gasson Street, Sydenham

Christchurch 8023

Week Days: 8.30am - 5.00pm

Saturday: 10:00am - 4.00pm

Sunday: By Appointment