HP Application Form Apply using our form below and we will be in touch as soon as possible. Step 1 of 21 4% First ApplicantTitle Mr Mrs Miss Ms Name First Last Date of Birth DD slash MM slash YYYY Ages of Children Maiden Name Nationality Church / Suburb Home Address . Suburb City Post Code How long have you lived there? Previous Address . Suburb City Post Code How long did you lived there? Living Status Home Owner Renting Boarding Mortgage Amount / Rent Amount How often do you pay rent? Weekly Fortnightly Monthly Home Phone Number Mobile Phone Number Email Address Facebook Address Known at work as Occupation Employer / Company Name Employer Address . Suburb City Post Code Work Start Time Work Finish Time Work Phone/Extn Number Vehicle Make Vehicle Model Vehicle Colour Vehicle Registration How often is your income paid? Weekly Fortnightly Monthly How much is your (weekly or fortnightly or monthly) income? Is that amount Net or Gross? Net Gross How long have you been employed? Years / Months Landlords Name / Home Owner - Bank & Branch Landlords Address . Suburb City Post Code Landlords Phone Number / Home Owner - Bank/Branch Phone Number Second ApplicantTitle Mr Mrs Miss Ms Name First Last Date of Birth DD slash MM slash YYYY Maiden Name Nationality Church / Suburb Home Address (if different from first applicant) . Suburb City Post Code How long have you lived there? Previous Address . Suburb City Post Code How long did you lived there? Living Status Home Owner Renting Boarding Mortgage Amount / Rent Amount How often do you pay rent? Weekly Fortnightly Monthly Home Phone Number Mobile Phone Number Email Address Facebook Address Known at work as Occupation Employer / Company Name Employer Address . Suburb City Post Code Work Start Time Work Finish Time Work Phone/Extn Number Vehicle Make Vehicle Model Vehicle Colour Vehicle Registration How often is your income paid? Weekly Fortnightly Monthly How much is your (weekly or fortnightly or monthly) income? Is that amount Net or Gross? Net Gross How long have you been employed? Years / Months Credit ReferencesFinance companies e.g. Aotea Finance / Car Finance, Money Shop, Clothing Truck Companies etcCredit Reference Company Name Branch Payment Weekly or Fortnightly? Weekly Fortnightly Payment Amount? Credit Reference Company Name Branch Payment Weekly or Fortnightly? Weekly Fortnightly Payment Amount? Power Company Referees / RelativesPlease supply four personal referees not living with you1st Referee Name First Last 1st Referee Mobile Number 1st Referee Address . Suburb City Post Code 1st Referee Relationship e.g. Parents, Brother & Sister, Aunty & Uncle, Close friends 2nd Referee Name First Last 2nd Referee Mobile Number 2nd Referee Address . Suburb City Post Code 2nd Referee Relationship e.g. Parents, Brother & Sister, Aunty & Uncle, Close friends 3rd Referee Name First Last 3rd Referee Mobile Number 3rd Referee Address . Suburb City Post Code 3rd Referee Relationship e.g. Parents, Brother & Sister, Aunty & Uncle, Close friends 4th Referee Name First Last 4th Referee Mobile Number 4th Referee Address . Suburb City Post Code 4th Referee Relationship e.g. Your cousin, Your friend etc. Privacy Act I/we agree to obtaining any credit report about my/our credit activities or credit worthiness from a credit reporting company.This won't necessarily affect your application with us as we are open to people with poor credit.Signature of applicants uploadMax. file size: 50 MB.Date MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.
