Loan Application Form

Complete the form below to introduce yourself to us. Fields with a red asterisk must be filled in.

How much do you want to borrow? *

Security *

Vehicle

Chattels

Other Security/Asset e.g. boat

What type of security do you have? You may choose more than one option

Do you have a New Zealand Driver's License? *

Yes

No

Credit History *

Great

OK

Had some issues

Don't know

What is your Credit History like?

Title *

Mr

Ms

Mrs

Miss

First Name(s) *

Last Name *

Date of Birth *

Occupation *

Tradesperson

Professional

Self Employed

Beneficiary

Beneficiary with Part-time work

What is your Occupation?

Enter your email address *

Mobile Phone *

Home or Work Phone

Best Time to Contact You *

8am - 12pm

12pm - 3pm

3pm - 6pm

Are you a NZ Resident or have a Valid Work Permit? *

Yes

No

Street Address *

City *

Region *

Residential Status *

Renting

Boarding

Own the home at the above address

Are you:

Credit Check Authorisation *

Yes

No

Do you give us permission to run a credit check on you?

Mon-Fri 9am to 5pm
06 835 0444

197 Marine Parade
Napier

Loan Application Form

Mon-Fri 9am to 5pm06 835 0444

197 Marine ParadeNapier

Loan Application Form

Mon-Fri 9am to 5pm
06 835 0444

197 Marine Parade
Napier