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Client Login 1
Application Form
*
Indicates required field
Amount Requested
*
Please list the maximum a
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
Residential Details
*
Rent
Board
Own
Own with mortgage
Living with Relatives
Name of Agent/Owner
*
Phone Number
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Monthly Rental
*
Enter mortgage payments or board amount if not renting
Date Moved In
*
Previous address if current address less than 3 years
*
Line 1
Line 2
City
State
Zip Code
Country
Marital Status
*
Single
Married
De-facto
Widow
Divorced
Number of Dependents
*
0
1
2
3
4
5 or more
If you have a spouse/partner - do they contibute to the household income?
*
N/A
Yes
No
Spouse/Partners Full Name
*
Spouse/Partner Weekly Income contribution
*
Employment Details
Current Employment Status
*
Full Time
Part Time
Casual
Self Employed
Centrelink Benefits
Contractor
Job Description/Title
*
Employers Full Name
*
List centrelink if receiving benefits or your business name and ABN if self employed or a contractor
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Employers Phone
*
List your own number if receiving benefits or your accountants umber if you're self employed
Date Commenced Work
*
Net Pay
*
List centrelink benefit amount if not working or average monthly earnings if self employed
Pay Frequency
*
Weekly
Fortnightly
Monthly
Previous Employer if less than 3 years with current job
*
List as above if in same
Employers phone
*
Previous Job Description/Title
*
Date Commenced Work
*
Summary of Assets and Liabilities
Assets
Cash/Bank
*
Real Estate
*
Motor Vehicles
*
Super
*
Shares/Managed Investments
*
Other
*
Include Household Contents, jewellery, antiques etc here
Liabilities
Personal Loan - Amt Borrowed
*
List 0 if no current Loan
Mortgage - Amt Borrowed
*
List 0 if no current Loan
Car Loan - Amt Borrowed
*
List 0 if no current Loan
Credit Card Limit
*
List 0 if no current Loan
Other Loans - Amt Borrowed
*
List 0 if no current Loan
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
*
Have you ever been bankrupt?
*
Yes
No
Are there any oustanding writs or summons issued against you?
*
Yes
No
Read our
privacy policy
here
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
.
Upload Drivers Licence
*
Max file size: 20MB
Upload Payslips
*
Max file size: 20MB
Application
*
I agree that the information I have given is true and accurate
Privacy Policy
*
I have reviewed, understand and consent to the 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.
I would like to be kept up to date
*
Yes, keep me up to date
No, I do not wish to be kept up to date
Name
*
Date
*
Any additional comments you'd like to make about your application.
*
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
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