Application

Amount Requested *

Purpose of Loan *

Personal Business

Purpose of the Loan *

How Did you hear about Village Finance? *

Name *

First

Last

Mobile *

Home Phone Number *

Email *

Date of Birth *

Drivers Licence Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Name of Agent/Owner *

Phone Number *

Monthly Rental *

Date Moved In *

Previous address if current address less than 3 years *

Line 1

Line 2

City

State

Zip Code

Country

Employment Details

Job Description/Title *

Employers Full Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Employers Phone *

Date Commenced Work *

Net Pay *

Summary of Assets and Liabilities

Assets

Cash/Bank *

Real Estate *

Motor Vehicles *

Super *

Shares/Managed Investments *

Other *

Liabilities

Personal Loan - Amt Borrowed *

Mortgage - Amt Borrowed *

Car Loan - Amt Borrowed *

Credit Card Limit *

Other Loans - Amt Borrowed *

PL Balance *

Mortgage Balance *

Car Loan - Balance *

CC - Balance *

Other Loans - Balance *

PL - Monthly Repayments *

Mortgage - Monthly payments *

Car Loan - Monthly Payments *

CC - Monthly Payment *

Other Loan - Monthly Payments *

By agreeing below, you consent to all of the terms and conditions outlined in our Privacy Notice and Consent including the General Privacy Policy, Credit Information Privacy Policy and Hardship Privacy Policy.

Direct Marketing
By ticking the box below you also agree that your personal information my be used for direct marketing of our products to you.

In order to finalise your application we need to collect the following documents from you.

Last 3 months bank statements (that's from this week back 3 months).
100 points of identification
A bill with your name and address on it
Last 3 payslips or 6 payslips if you are casual or part time
Last 2 years tax returns and assessments if you are self employed

Application Form

Employment Details

Summary of Assets and Liabilities

Assets

Liabilities