Application Form

(Please tick here.) Permission to do a credit check via Equifax

Surname

First Name / Middle Names

DOB

Current Address (if you have been there less than 3 years please put previous address as well)

E-mail

Home Phone

Mobile

Residential Status

How much do you pay in Rent, Mortgage, Board etc..

Frequency of Rent, Mortgage, Board etc...

MUST HAVE PHOTO ID OF EITHER NZ DRIVERS LICENCE, 18+ CARD OR PASSPORT AND MUST BE NZ RESIDENT

Occupation

Employer

Income (How much is paid into your bank each pay)

Frequency of Income : Weekly, Fortnightly, Monthly?

What sort of Income

Amount you wish to borrow and reason for loan?