Loan Application Form

1
Name* This field is required.
First Name
Last Name
2
Marital Status:* This field is required.
Single
Married
Other
3
E-mail* This field is required.
4
Phone* This field is required.
Area Code
Phone Number
5
What suburb do you live in?* This field is required.
6
Occupation* This field is required.
7
Gross monthly income* This field is required.
8
Monthly rent/mortgage* This field is required.
9
What are you looking to spend?* This field is required.
10
House deposit* This field is required.
11
Type a question
First Home Buyer
Second Home
Holiday Home
Rental Property
Other
12
How far in the process are you?
Just getting started, looking to see how much I can borrow
I'm ready, looking to get pre-approved
13
Which bank do you bank with?
ANZ
ASB
BNZ
Kiwibank
Westpac
Other
14
Comments:
15
Please advice the best time to contact you:
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: