Mon-Fri 9am to 5pm
06 835 0444
197 Marine Parade
Napier, NZ
Home
Debt Consolidation
Personal Loans
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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?
*
Loan Purpose
*
Bill Payments
Car Purchase
Car Repairs
Debt Consolidation
Family Reasons
Home Improvements
Other Purchase
Personal
Tax Payment
Travel
What do you want this loan for?
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
*
Northland
Auckland
Waikato
Bay of Plenty
Gisborne
Hawke's Bay
Taranaki
Manawatu-Wanganui
Wellington
Tasman
Nelson
Marlborough
West Coast
Canterbury
Otago
Southland
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?
Submit
