Credit Application Form
Please fill out your details to apply for business financing.
Business legal entity information
Business details - Entity
*
Legal Name of Business (if Trust - full official name)
Business details - Trading name
Trading Name - if different to legal name
Business Registration Details
*
NZBN
Industry - type of business
*
Nature of Business
Business Legal Structure
*
Please Select
Company
Trust
Partnership
Sole trader
Not for profit
Club
Trustee Entity (e.g. Company or Individual)
Trustee entity name(s) - Company / Individual(s)
Contact details
Business Phone Number
*
-
Area Code
Phone Number
Contact person's Name
*
Full Name
Contact person's Email Address
*
example@example.co.nz
Contact person Mobile Phone / Number
*
-
Area Code
Phone Number
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Business address details
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Post code
Years in Business
*
Due to operating your business for less than 2-years, please provide further background in relation to your relevant Industry or Business experience in the box below. To support this, can we also please obtain your last recent 2x IRD Income Tax Returns (upload box below)
Upload area for IRD Tax Returns - if available or these can be emailed at a later stage
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Finance request details
Requested Finance Amount (NZD)
*
Dealer / Supplier of Equipment (if known)
Supplier Name
Name of Dealer Sales Rep (if known)
Sales person name
Preferred Loan term
2-years
3-years
4-years
5-years
Equipment being Purchased / Purpose of Finance
*
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Directors details
Director One Full Name
*
First and Middle Names
Last Name
Director One Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Mobile Phone Number
Are you a Property Owner or Renter Only? This information will assist to avoid a deposit requirement. Property owners (your residence or investment property) can finance the full amount - whereas non-property owners need to contribute a 20% deposit. All facilities are secured only over the Equipment being Financed
*
Own or mortgage a property
Renter (do not own any form of property)
Property Address where owned
Property value
Mortgage value
Rental $ per mth
Rental cost
Asset & Liability Statement: Please provide a basic summary of your Personal Assets and Liabilities - e.g. Car and Car loan, Savings, Contents, Credit card etc.
Rows
Asset Description:
Asset Value $:
Liability Description:
Liability Value $:
1:
2:
3:
4:
5:
Director One Driver's Licence Upload OR
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Take Photo
Signature - Director One
*
Click if there is a Second Director
Director Two Full Name
First and Middle Names
Last Name
Director Two Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Are you a Property Owner or Renter Only? This information will assist to avoid a deposit requirement. Property owners (your residence or investment property) can finance the full amount - whereas non-property owners need to contribute a 20% deposit. All facilities are secured only over the Equipment being Financed
Own or mortgage a property
Renter (do not own any form of property)
Property Address where owned
Property value
Mortgage value
Rental $ per mth
Rental cost
Upload Director Two Driver's Licence
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Drag and drop files here
Choose a file
Cancel
of
OR Take Photo
Signature - Director Two
Click if there is a Third Director
Director Three Full Name
First and Middle Names
Last Name
Director Three Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Are you a Property Owner or Renter Only? This information will assist to avoid a deposit requirement. Property owners (your residence or investment property) can finance the full amount - whereas non-property owners need to contribute a 20% deposit. All facilities are secured only over the Equipment being Financed
Own or mortgage a property
Renter (do not own any form of property)
Property Address where owned
Property value
Mortgage value
Rental $ per mth
Rental cost
Upload Director Three Driver's Licence
Browse Files
Drag and drop files here
Choose a file
Cancel
of
OR Take Photo
Signature - Director Three
Upload File
Submit Application
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