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Loan Details

$ Amount required
(minimum loan amounts apply)

*

Reason for loan
(e.g. car loan, debt consolidation, bill payments)

*

Have you had a loan with Instant Finance before?

Yes No *

Would you like to include a co-borrower?
e.g. a partner who lives with you

Yes No *

How did you hear about Instant Finance?

*

Applicant Details

Main Borrower

Co-Borrower

Title

*

First name

*

Middle name(s)

Surname

*

Other name
(e.g. maiden name, married name)

Marital status

*

dd/mm/yyyy

Date of birth

*

How many dependants do you support financially?

*

Are you a NZ resident?

Yes No *

Contact Details

Main Borrower

Co-Borrower

Home phone
(Include area code)

Work phone
(Include area code)

Mobile phone

Best contact number

*

Email

*

Current Address

Same as Main Borrower

Main Borrower

Co-Borrower

Street number and name

*

Suburb

City

*

How long have you lived there?

*

Do you…

*

$ How much do you pay?

*

$ *

Week Fortnight Month *

Current Employment

Main Borrower

Co-Borrower

Occupation

*

Employer

*

How long have you worked there?

*

Employment type

*

Take home pay after tax $

*

$ *

Week Fortnight Month *

Do you receive any extra income?

Please complete the boxes below only if you receive additional income.

Main Borrower

Co-Borrower

$ Additional take home pay after tax

$

Week Fortnight Month

Where do you receive this from?
(e.g. Part-time job, rental income, boarder, family assistance, etc)

Assets

House

Main Borrower

Co-Borrower

$ Market value

$

$ Mortgage Balance

$

Vehicle 1

Main Borrower

Co-Borrower

Make & Model

Year

Registration

Financed

Yes No

Finance company

Vehicle 2

Main Borrower

Co-Borrower

Make & Model

Year

Registration

Financed

Yes No

Finance company

Chattels

What is the approximate value of all the household contents that you own?
(e.g. Furniture, TV, stereo, appliances etc)

Main Borrower

Co-Borrower

$

Liabilities

Type of liability

Company

Limit

Current balance

Payment

Payment frequency

$

W F M

$

W F M

$

W F M

$

W F M

$

W F M

$

W F M

$

W F M

$

W F M

Additional comments

Please include any additional information you feel is important

TERMS AND CONDITIONS

THE PRIVACY ACT 1993 By accepting the terms and conditions:

1. I/We understand that all personal information (“personal information”) Instant Finance NZ Limited (“you”) holds about me, whether now or in the future, will be used to assess my credit worthiness and financial position (from time to time), and to process and assess any application for credit I have made with you.

2. I/We authorise:

• you to make enquiries about me, disclose personal information to any third party (eg. disclosing default information) and/or obtain information about me that you consider necessary from such third party for the purposes set out in paragraph 1 or to collect any outstanding debt from me, or for any other enforcement by you. In this regard I authorise such third party to provide to you information about me that you consider necessary for such purposes;

• you to disclose information about me (where required) to your insurers, potential assignees, credit rating and credit reporting agencies such as Veda Advantage;

• you to use any of the personal information about me for the purposes of informing me about your other products and services.

3. I/We understand that I have the right to access and correct personal information held by you by contacting you on 0800 260 000.

4. I/We understand that all information you provide to Veda Advantage (including my/ our default information) will be held by Veda for its credit reporting service and Veda may give such information to its customers who use its service. I/We also understand that I/ We may access and correct the information held by Veda by writing to Veda at Private Bag 92156, Victoria Street, Auckland.

5. I/We declare that the information I have provided to you in any application for credit is correct and complete and I agree to immediately advise you of any change to any information contained in any such application.

6. I/We understand that you reserve the right to decline any application for credit .

7. I/We agree that personal information may be transmitted between ourselves or by you to any third party (for the purposes set out above) using facsimile and/or electronic mail.

Main Borrower * Co-Borrower *

8. I/We acknowledge that there are security risks associated with the electronic transmission of information.

I have read and accept these terms and conditions Main Borrower * Co-Borrower *

(Please note that Main Borrower cannot authorise acceptance on behalf of the CoBorrower)