Financial Hardship

Personal Details

1. What is the cause of your financial hardship?

2. When did this begin to impact you and what is the financial impact?

3. How long do you think this situation will continue?

^*If you expect your difficulties to be short term, please provide any documentation to confirm the likelihood of these changes such as – medical reports, employment contracts etc.

What changes in your circumstances do you expect will happen and when?

Why do you think you will be unable to meet your obligations under your credit contract during this time?

4. How do you propose that your loan should be varied on account of your financial difficulties?

and reduce the amount of each payment due under the contract accordingly without a consequential change being made to the actual

interest rate or annual interest rates;

without a consequential change being made to the annual interest rate or annual interest rates

Both:

and reduce the amount of each payment due under the contract accordingly without a consequential change being made to the actual

interest rate or annual interest rates;

without a consequential change being made to the annual interest rate or annual interest rates;

5. Number of dependants?

6. Please tell us anything else that may be relevant to your situation.

Financial Position Statement

1. What is your current monthly household income after Tax?

^*Please provide copies of relevant documents, including recent payslips, Work and Income New Zealand statements, bank statements etc. to support your declaration.

Other Income
(please indicate source)

2. What are your household monthly living expenses?

Other
(please indicate type)

3. What are your current debt obligations and the minimum monthly repayments?

^*Please include the names of the lender.

4. What are your other assets and their value?

Please attach all supporting documentation below