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Personal Loans - Apply for a loan

* Indicates a required field.

* AMOUNT WANTED $ * PREFERRED PAYMENT $ * WK FT MTH
REASON FOR LOAN SECURITY FOR LOAN

CLIENT FEEDBACK - Where did you hear of us?

1st Applicant

Mr     Mrs     Ms
* First names * Surname * D.O.B
Are you known or previously known by any other name?
Yes   No    
Have you changed your name by statutory declaration in the past three years
Yes   No    
* ARE YOU Married Defacto Separated Single
* DO YOU Own home Rent Board Live with Relatives
* PHONE NO WORK MOBILE
Best time to contact you
CURRENT ADDRESS How long
Previous address How long
Previous address How long
Postal address (if different from above)
EMPLOYMENT DETAILS - Beneficiary Yes No
* Occupation Full time Part time Casual Self employed
Company Name
Company Address
How long at current job Years Months
PREVIOUS EMPLOYMENT Company Name How long at this job Years Months

2nd Applicant

Mr     Mrs     Ms
First names Surname D.O.B
Are you known or previously known by any other name?
Yes    No    
Have you changed your name by statutory declaration in the past three years
Yes    No    
ARE YOU Married Defacto Seperated Single
DO YOU Own home Rent Board Live with Relatives
PHONE NO WORK MOBILE
Best time to contact you
CURRENT ADDRESS How long
Previous address How long
Previous address How long
Postal address (if different from above)
EMPLOYMENT DETAILS - Beneficiary Yes No
Occupation Full time Part time Casual Self employed
Company Name
Company Address
How long at current job Years Months
PREVIOUS EMPLOYMENT Company Name How long at this job Years Months

3 Personal Contacts

(Please give full names - a minimum of 1 relative must be given)
1 Closest relative Relationship
Address
Phone no Work Phone Mobile
2 Closest relative Relationship
Address
Phone no Work Phone Mobile
3 Closest relative Relationship
Address
Phone no Work Phone Mobile

Financial Details

* (Please list any current payments you are making to service Loans, Hire Purchase, Credit Cardsetc...)
Who are you paying Security Used Current Balance Payment Amount WK FT Mth
* How many people do you support financially? How many vehicles do you run?
Vehicle Make Model Registration
Vehicle Make Model Registration
Vehicle Make Model Registration

Income

wk ft mth Amount

Expenses

wk ft mth Amount
1st Applicant net wages Rent / Mortgage
2nd Applicant net wages Food
Phone (inc mobile)
1st Applicant benefit Power / Gas
2nd Applicant benefit HPs / Loans
Credit Cards
Family Support Petrol / Diesel
Insurances (inc life)
Part time job Rates / Water Rates
Clothing etc...
Other income / month Spending money
Paying Boarders 10% of expenses for emergencies
Total Income / Month (A) Total Expenses / Month (B)
Disposable Income / Month (A - B)


Yes, I have read and understand the privacy declaration below.

Privacy declaration (Privacy Act 1993)

I/We declare that all information provided on this Application Form is true and correct. I/We understand that Credit Checks and PPSR Checks will be obtained to enable the processing of this Application. I/We declare that no money is owed on the security being provided other than that which has been stated. I/We declare that I am/we are not undischarged bankrupts. I/We irrevocably agree that Geneva Finance may give to and seek from credit providers, credit reporting agencies, my/our employer/s, relative/s or other named person/s such personal, financial and commercial information as is necessary relating to this credit application, the administration of any loan and any ongoing debt recovery. I/We acknowledge that any costs relating to debt recovery are payable by me/us and that a default may be recorded against my/our credit history for non-payment of debt/s incurred with Geneva Finance. I/We understand and agree that the information on this form may be exchanged with other credit providers or other third parties to assist the recovery of my/our debt.

I/We declare that I/We am/are not known by any other name and that there are no official documents in NZ or overseas showing me/us with any other name or form of name.