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General Loan Information

Loan Type
Quickdraw Loan with Redraw/Top-Ups
Home Owner's Consolidation Account
 
 
What is the purpose of your loan?
Loan amount *
$
Where did you find us?*

 

 

Personal Information - Primary Applicant

Title
First Name: *
Middle Name:
Last Name: *
Date of Birth Sex
*
Marital status
Number of dependants:
Drivers Licence Number (5a): Version (5b):
Residential status *
Home Address: *
How long have you lived at this address?
Home Phone:
Work Phone:
Email Address:*
Mobile Phone number:
Social Media Address:
Employment status:
Current Employer:
Title/Job Description:
Current Employer phone number:
Time at current employer:
Work Address:
If less than 2 years - Previous Employer:
Time at previous employer:

Husband/Wife/Partner or Secondary Applicant

Title
First Name:
Middle Name:
Last Name :
Date of Birth Sex
Drivers Licence Number (5a): Version (5b):
Residential status
Home Address:
How long have you lived at this address?
Home Phone:
Work Phone:
Email Address:
Mobile Phone number:
Employment status:
Current Employer:
Title/Job Description:
Current Employer phone number:
Time at current employer:
Work Address:
If less than 2 years - Previous Employer:
Time at previous employer:



 

Financial Information - Income

Primary Applicant income (after tax)
$
Secondary Applicant income (after tax)
$
Additional income (after tax)
$
Details:
Total Income (after tax)*
$

Expenses

Mortgage/Rent
$
HP/Credit Card/Loan Payments
$
Other
$
Details:
Total Expenses*
$


 

Assets (what do you own)

  Value Mortgage
Property $ $
  Value Money Owing
Other Assets $ $


 

Vehicle 1

Make and model Registration


 

Next of kin or alternative contact person 1

Name Phone Relationship
Address (person not living at your address)


 

Setting up your payments

Preferred payment frequency* Preferred payment amount*
$
Next pay date being

I would like to have my payments deducted directly from my wages (subject to my employers approval)



OR

I would like to make payment directly from my bank account by automatic payment


 

Bank Account details

Bank Name: Bank Branch
A/C Holder Name: A/C Number:


 

Additional Information

Declaration and Privacy Waiver:

1. I hereby declare that the information provided on this Application Form to New Zealand Finance and Loans Ltd (hereafter called "the Company") is true and correct...more

I have read and accept the terms of this Declaration and Privacy Waiver: *

Applicant/s:

 I/we agree
 

I declare that I am (Please select from the drop down below) *

 

Are you an un-discharged bankrupt? *

 

Have you ever made application to the Official Assignee for a "No Asset Procedure" form of bankruptcy? *

Additional Comments:

 

Please enter the verification code in the image below
*