Loan Application

1. Your personal details

ACU Member Number
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Title(*)
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First Names(*)
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Last Name(*)
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Date of Birth(*)
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What is your gender?(*)
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What is your marital status?(*)
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Are you a permanent resident of New Zealand?(*)
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How many dependant children do you have?(*)
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How did you hear about Aotearoa Credit Union?(tick as many as apply)

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Are you employed?(*)

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What is your occupation?
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Employers Name
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Employer's Address
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How long have you been employed there?
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What is your drivers licence number?
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What type of licence do you hold?
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Upload Photo I.D.(*)
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2. Your contact details

What is your home address?(*)
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What type of residence is this?(*)
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How long have you lived at this address?
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What was your previous address? (if under 3 years at current)
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Upload Proof of Address
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What are your phone numbers and email address?
Home phone number
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Mobile number
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Work Number
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Fax number
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Email Address(*)
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Please provide contact details of TWO relatives or friends in New Zealand, NOT living with you:
Person 1
Name
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Address
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Home phone number
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Mobile number
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Relationship to you
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Person 2
Name
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Address
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Home phone number
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Mobile number
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Relationship to you
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3. Joint applicant’s details (if applicable)

Title
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First Names
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Last Name
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What is your date of birth?

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What is your gender?
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What is your marital status?
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Are you a permanent resident of New Zealand?
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How many dependant children do you have?
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Are you employed?

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What is your occupation?
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Employers Name
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Employer's Address
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How long have you been employed there?
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What is your drivers licence number?
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What type of licence do you hold?
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4. Loan details

How much would you like to borrow?
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What is the purpose of the loan? (Please provide full details?
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What are you offering as security for this loan? (please tick and complete as many as apply)

Motor Vehicle or Boat
Registration number
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Vehicle make
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Vehicle model
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Estimated value of vehicle
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Is the vehicle insured
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Type of insurance
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Savings
Value of savings
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Household Contents
Value of household contents
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Upload Bank Statement(*)
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1 month bank statement if paid weekly 2 months if paid fortnightly 3 months if paid monthly

 
What do you own?
Home
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Household contents
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Motor vehicle/s
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Savings
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Other properties (please specify)
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Total Assets
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What do you owe?
First Mortgage
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Second Mortgage
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Motor vehicles
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Credit/Store card debt
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Personal loans/Hire purchases
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Total Liabilities
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Notes to the above
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7. Income & Expenditure

Please fill in the table below and tick the appropriate letter to show how often you are paid/pay each item. W = weekly, F = fortnightly, M = monthly
Net income after tax
How often?
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Amount
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Other income (please specify)
Other Income
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How often?
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Amount
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Other Income
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How often?
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Amount
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Total Income
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Expenditure
Mortgage/Rent/Board
How often?
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Amount
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Other loans
How often?
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Amount
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Insurances
How often?
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Amount
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Credit/Store card repayments
How often?
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Amount
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Hire purchase repayments
How often?
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Amount
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Food/Living expenses
How often?
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Amount
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Total Expenditure
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Have you ever been declared bankrupt?
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If yes, what year were you declared bankrupt?
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Have you been admitted to the no asset Procedure?
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If yes, what year
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8. Declaration

  • From time to time, Aotearoa Credit Union (including selected third parties) may use the information (“information”) I have provided to Aotearoa Credit Union to send me information of any products or services that Aotearoa Credit Union thinks may be of interest to me/us.
  • I/we understand that the information will be used to access my/our credit worthiness and financial position, to process and assess my application and for the management, assessment, enforcement (including disclosing default information to any credit reporting agency, including Veda (“Veda”) of any agreement I/we have with Aotearoa Credit Union.
  • By signing this application, I /we authorise Aotearoa Credit Union (for the purpose listed above) to: • make enquiries about me and disclose and obtain any additional information Aotearoa Credit Union considers necessary; • disclose my/our personal information to potential assignees, to credit rating and credit reporting agencies (such as Veda) and any other person that Aotearoa Credit Union may appoint to collect any outstanding debt from me/us.
  • I/we understand that I/we have the right of access to and correction of, all personal information held by Aotearoa Credit Union that relates to me by writing to Aotearoa Credit Union, PO Box 200-175, Papatoetoe
  • I/we understand that all information Aotearoa Credit Union provides to Veda including information relating to any default by me/us of any obligation to Aotearoa Credit Union 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 may access and correct the information held by Veda by writing to Veda, Private Bag 92165, Victoria Street, Auckland.
  • I/we declare that the information i have provided in this application is correct.
Todays date(*)

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