Online Application Form1 2 3 4 5 How much would you like to borrow?*Please enter a number greater than or equal to 800.Our minimum loan value is $800. Please enter an amount greater than or equal to this.How much can you pay weekly?*Please enter a number greater than or equal to 1.Our customers usually pay $25-50 a week depending on the size of the loan. Choose an amount that feels right for you.Your First Name*Your Email Address* Your main contact number*Please include area code. What will the money be used for?*please selectCar repairsCar purchaseHealth expenses (i.e. medical or dental)Personal holidayPersonal event (i.e. wedding or funeral)Home renovationDebt consolidationBusiness equipmentI'm a Supporting Borrower for another applicationOtherLet us know what you need this for. If you are a Supporting Borrower, there is an option for this here also.Please specify what the money will be used for?*What is the name of the person you are applying as a Supporting Borrower for?*Your DetailsYour Title*MrMrsMissMsYour First Name*Your Middle NameYour Last Name*Are you known by any other name? If so, what name?Marital Status*please selectSingleDe Facto, Married, or Civil UnionSeparated or DivorcedWidowedDate of Birth* DD MM YYYYYour main contact number*Your other contact number (optional)Please include area code.What is your current living situation?*please selectOwn HomeRenting / FlattingLiving with parent Your Current Residential AddressNumber & Street*SuburbCity*How long have you been at this current address?*please selectLess than 6 months6 months - 1 year1 - 2 years2 - 5 yearsMore than 5 yearsYour Previous Residential AddressNumber & Street*SuburbCity*How long have you been at this previous address?*please selectLess than 6 months6 months - 2 year2 - 5 yearsMore than 5 yearsWhat were the main reasons you moved house in the past two years?* Your IDYour ID type*New Zealand Drivers LicencePassport (can be from any country)Other (Photo ID, 18+ card, firearms licence, etc.)Driver's license number (5a)*Driver's license version (5b)*When does your drivers licence expire (4b)* DD MM YYYYPassport number*Passport country of issue*When does your passport expire (Month and Year)?*ID type*ID reference number*When does your ID expire (Month and Year)?*Loan security and collateralWhat's the most valuable thing you ownI don’t have enough security myself but I will have a supporting borrowerA house and/or propertyA vehicleHousehold goods like appliances, furniture, electronic items, etc.OtherThis is what we use as security for your loan so it needs to be worth at least as much as the amount you're borrowing.Supporting borrower's name*Supporting borrower's phone*Make and model of your vehicleYear of vehicle's manufacture*Vehicle plate/reg*Name of vehicle insurer*Do you owe money on the vehicle?No, I fully own itYes, I'm paying it offWho do you owe the money for the vehicle to?*Please describe this item*We will require some form of security from you. This could be a vehicle, furniture, TV or other household items. If you are not able to provide security, then a family member or a friend can act as a “supporting borrower” (if they can provide security on your behalf). Your occupation I'm a beneficiaryYes, we lend to beneficiaries.Your current job or occupation*Name of the place where you currently work*If you're a student, put your place of study. If you're unemployed, just put "none"Phone number of your workplace*How long have you been in your current job?*please selectLess than 1 year1 - 1.5 years1.5 - 2 years2 - 3 yearsMore than 3 yearsYour previous job or occupation*Name of the place where you previously worked*How long have you been in your previous job?*Less than 1 year1 - 1.5 years1.5 - 2 years2 - 3 yearsMore than 3 yearsYour Partner's DetailsBecause your partner may jointly own some of the assets you listed previously, they may need to be a "joint borrower".Your partner's Title*Your partner's First Name*Your Partner's Last Name*Your partner's phone number*Your partner's Email Address* Your partner's Date of Birth* DD MM YYYYIs your partner happy for you to give us the details above?* Yes, my partner has given me permission to use their details for this loan Terms and Conditions I/We warrant that the information given above is true and correct and hereby AUTHORISE this lender making all enquiries and obtaining all information it shall deem necessary at its discretion. I/We AUTHORISE all companies, institutions, credit agencies, organizations and other persons approached by this company for information about me/us to provide the information requested. i/We acknowledge that this company shall not be required to comply with the provisions of Principle 3 of the Privacy Act 1993 as to whether I/We shall be aware of: the fact that the information is being collected, the purpose for which the information is being collected, the intended recipients of the information, the consequences for providing information, the rights of access to and correction of such information, or that the collection of the information is authorized or required by or under law If you agree to these Terms and Conditions you can submit your loan application now:Have you been declared Bankrupt before or currently Under Summary Instalment Order or No Asset Procedure?*Please selectNoYesUnsureTerms and Conditions* I agree to the Terms and Conditions above.Email Consent I agree to be contacted via email This iframe contains the logic required to handle Ajax powered Gravity Forms.