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Credit Union Loan Application Form

To help us approve your loan faster, please complete this form with as much information as possible. We will contact you within the next working day to let you know if your loan has been approved or if we require more information.

All required fields marked with *.

Customer Number
Are you an existing customer?
If yes, Customer Number

Loan Details
Loan Required $ * Term of Loan *
Purpose Of Loan * Details

Personal Details
Main ApplicantJoint Applicant
Title * Title
Surname * Surname
First Name * First Name
Middle Name Middle Name
Date Of Birth * Date Of Birth
No. Of Dependents * No. Of Dependents
Marital Status * Marital Status
Home Address * Home Address
Suburb Suburb
City * City
Residential Status * Residential Status
Rent/Mortgage Paid Per Month $ * Rent/Mortgage Paid
Per Month $
How Long Have You Lived Here? * How Long Have You Lived Here?
Previous Address
(if less than 3 years at current)		 Previous Address
(if less than 3 years at current)
How Long Were You There For? How Long Were You There For?
Home Phone (With Area Code) Home Phone (With Area Code)
Work Phone (With Area Code) Work Phone (With Area Code)
Mobile * Mobile
Email Address * Email Address
Current Occupation * Current Occupation
Employed By * Employed By
Employment Address * Employment Address
Employment City Employment City
How Long Have You Worked Here? * How Long Have You Worked Here?
Previous Occupation
(if less than 3 years at current)		 Previous Occupation
(if less than 3 years at current)
Previous Employer Previous Employer
How Long Did You Work There? How Long Did You Work There?
Monthly Take Home Pay ( After Tax ) $ *
(proof of this required)		 Monthly Take Home Pay ( After Tax ) $
(proof of this required)

Asset Details
Please fill out as best you can - if there is not enough room save any extra details for the big box at the end of the page. If you are offering your Car/Boat as security, please tell us the Make, Model and Year of the car.
What are you offering as security: *
Car/Boat 1Car/Boat 2
Car/Boat Value $
Car/Boat Make
Car/Boat Model
Year
Financed By
Amount Owing $
Registration Number
Only fill this out if you OWN the property:
Property 1Property 2
Address
Value (GV or Registered Value) $
Mortgage Balance $
Asset Details
Vehicles $
Home Contents $
(approximate or insured)
Other $

Current Financial Outgoings
Type Owed To Monthly
Payment $		 Amount
Borrowed/
Card Limit $		 Amount
Owing $		 Will this be consolidated?

Reference
Nearest relative not living with you - these people are not contacted
Name *
Address *
Phone *

Other Details
Best time to contact me
I can be contacted on
Where did you hear about us?
I have read and accept the Privacy Acknowledgement. *
Other Information which might assist us with your application - any extra liabilities that you could not fit in the application form, bad credit history or anything else you need to disclose.

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