HP Application Form Apply using our form below and we will be in touch as soon as possible. Step 1 of 21 4% First ApplicantTitleMrMrsMissMsName First Last Date of Birth Date Format: DD slash MM slash YYYY Ages of ChildrenMaiden NameNationalityChurch / 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 StatusHome OwnerRentingBoardingMortgage Amount / Rent AmountHow often do you pay rent?WeeklyFortnightlyMonthly Home Phone NumberMobile Phone NumberEmail AddressFacebook Address Known at work asOccupationEmployer / Company NameEmployer Address . Suburb City Post Code Work Start TimeWork Finish TimeWork Phone/Extn Number Vehicle MakeVehicle ModelVehicle ColourVehicle Registration How often is your income paid?WeeklyFortnightlyMonthlyHow much is your (weekly or fortnightly or monthly) income?Is that amount Net or Gross?NetGrossHow long have you been employed? Years / Months Landlords Name / Home Owner - Bank & BranchLandlords Address . Suburb City Post Code Landlords Phone Number / Home Owner - Bank/Branch Phone Number Second ApplicantTitleMrMrsMissMsName First Last Date of Birth Date Format: DD slash MM slash YYYY Maiden NameNationalityChurch / 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 StatusHome OwnerRentingBoardingMortgage Amount / Rent AmountHow often do you pay rent?WeeklyFortnightlyMonthly Home Phone NumberMobile Phone NumberEmail AddressFacebook Address Known at work asOccupationEmployer / Company NameEmployer Address . Suburb City Post Code Work Start TimeWork Finish TimeWork Phone/Extn Number Vehicle MakeVehicle ModelVehicle ColourVehicle Registration How often is your income paid?WeeklyFortnightlyMonthlyHow much is your (weekly or fortnightly or monthly) income?Is that amount Net or Gross?NetGrossHow long have you been employed? Years / Months Credit ReferencesFinance companies e.g. Aotea Finance / Car Finance, Money Shop, Clothing Truck Companies etcCredit Reference Company NameBranchPayment Weekly or Fortnightly?WeeklyFortnightlyPayment Amount?Credit Reference Company NameBranchPayment Weekly or Fortnightly?WeeklyFortnightlyPayment Amount?Power Company Referees / RelativesPlease supply four personal referees not living with you1st Referee Name First Last 1st Referee Mobile Number1st 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 Number2nd 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 Number3rd 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 Number4th 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 uploadDate Date Format: MM slash DD slash YYYY PhoneThis field is for validation purposes and should be left unchanged.
