For Pacific staff use only, please comPlete

online

ConsumerLoansApplicationForm
PropertyInvestmentLoans'
is to be usedfor HomeLoans,Residential

does not ensure the approval of your credit application. You should complete all sections of the application t0

the informationwe will requireto undertakeour assessment.

From (submifuing Officer's name -\

S U R N A M Ef i r s t )
a
origin of Application - TyPe x as aPproPriate
Other

ADDlicantl

Title

:_::tffi

Applicant2-Surname

Title

i.

- Surname

rT
1...."............"."-"*-..-.....

Date of Blrth

address
Mths
P r e v i o u sr e s i d e n t i a lE
M o b i l eN u m b e r

Type X as appropriate

PropertyPurchase

L o a nP u r p o s e :

Refinance Sought

Loan1 PurposeDescription:

loan z PurposeDescription:

AmountRequired

Other

Purchase Vacant Land

PropertyType:

l_.-'---_"

"*_-_*

O.ooI

L o a ns o u g h t l

_"_-* I

R e p a y m e nmt e t h o d

--lKff"'_

LAF 2 (if any):

LAF 1:

----**-^*-*
|
(tt-r-s-r-oat--,---(rit-l-s:l9gl,
sougnr
Loan ferm
LOan
term sought

Total

L o a n l - M o n t h ( s )i

other/3rd Priority Funding

*---..................1
-i;;^
......................___
i-^".+"
I drn Tvhe Details

Pleasestate your ANz

accountnumber(if any)

Total
(selectfromtledropdown
list)

Loan 2 - Month(s)

Loan2 (if any) MonthlvFee(eg. LAC)

Loanl MonthlyFee(eg. LAc)

t--l

Freq

Details of property

offerd

as Security

t o" l:::*--:-l

Held/To Be Taken

Page 1 of 2

o Position
Statement
(Limit
Bank - OD
- Small Loan

Bank

- Cheque Acs
- Access/Savings

- Other (Ten

- Pe6onal Loan
- N'licro ban

Deposits

- Other Loan
lvlastercard (No,
(Umit

Z Visa(No
(Limit
ANz Mortgages/Loans
Asset charged

to

Bank's Credit Cards (Incl Amex etc)

on life policies

Other Bank Mortgages/Loans

Asset charged
to

Asset charged

axation due

loans being
otal liabilities

with

toEl

(if not deducted tum income, ___

re ins and runningexpenses

expenses (food/cloth ing & personal)

(eg. medial benefits, teleqhone)

Monthly income
Total Monthly outgoings

provide the appllcant with the

ANZ collects your information for the purpose of identifying you, assessing the applicant's appllcation and, if approved, to
product or seruice applied for. If you do not provide some or ali of the informatlon requested, ANZ may not be able to do these things. By slgning this
application form, you agree that ANz may use and disclose your information:
(a) to help ANz provide or tell you about other ANz products or services whlch may interest you;
Banking Group Limlted ABN 11 005 357 522 for internal and
iUi to retiteO companies (including subsidiaries) of Australia and New Zealand
training, and market or
administrative and operationat purposes (including rlsk management, systems development and testing, credit scoring, staff
customer satisfaction research);
(c) to obtain a credit report abbut your commercial activltles and commercial credit worthiness from any business which provides that type of
iniormation to assess the appticani's application and/or to accept you as a guarantor of credit applied for by the applicant;. your obligations
(d) to another credit provider to: assess the applicant's application, to assess your credit worthiness, to help you avoid a default on
or to tell a credit provider of any default you have made;
(e) to credit reporting or debt collecting agencies, any outsourced provider, agents, contractors or advisers ANZ engages to carry out its functions and
activities, ANZ,Salliance partners, and to other parties authorised and/or required by law to collect your information.

This privacyand confidentialitystatementapplieslf you are the appticantor a third party retevantto an aPplicant(or examplea guarantor)'
(To be signed by all individual applicants and by existing guarantors)

My signature below evidences my understanding and consent to all matters set out in this application including the Privacy and Confidentiality
and is given in support
Statement above. I confirm that all information provided by me in and/or accompanying this application is true and correct
of this application.
I declare that the details contained within the Statement of Financial Position are true and correct.
may not be able to
I acknowtedge that ANZ reserves the right to ask for additional information to consider the applicant's application and that ANZ
assess the applicant's application unless I provide additional information requested by ANZ.

A p p l i c a n t s' si g n a t u r e
A p p l i c a n t s' si 9 n a t u r e

1-_--

-^-)

( A l la p p l i c a n ttso s E n )

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