FINANCIAL HARDSHIP APPLICATION.

Please fill in the form below to apply for Hardship. Whilst we understand some of the questions in the application may be difficult to answer, this information will help us to provide the most suitable hardship option for you.

If you need any assistance completing the form, please contact our Hardship team on 1800 333 636 or via This email address is being protected from spambots. You need JavaScript enabled to view it.. We are here to support you.

Hardship Questionnaire

Customer Name*

Contact Number*

Email Address*

Finance agreement number

Vehicle Registration*

1. What is the cause of your financial hardship?

Nature of Hardship

Other (please specify below)

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.

Time frame

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. Please propose how you would like your loan to be varied on account of your financial hardship?

Please propose a reasonable plan and explanation on how you will be able to meet your obligations if hardship assistance is provided.

What amount, if any, you are able to contribute to your monthly loan repayments at the moment

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, Centrelink statements, bank statements etc. to support your declaration.

Salary

Business Income

Centrelink Benefits

Child Support

Other Income
(please indicate source)

Source

Income

Source

Income

2. What are your household monthly living expenses?

Mortgage/Rent

Council Rates

Total Utilities bills
(gas/water/electricity)

Telephone/ Mobile

Food

Clothing

Entertainment

Insurance(s)

Medical

School Fees

Other
(please indicate type)

Expense

Cost

Expense

Cost

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

^*Please include the names of the lender.

Home Loan	Balance	Monthly Payment	Amount Outstanding

Personal Loans/ Credit Cards	Balance	Monthly Payment	Amount Outstanding

Other Debts	Balance	Monthly Payment	Amount Outstanding

4. What are your other assets and their value?

Property (s)

Asset Value

Asset Description

Vehicle (s)

Asset Value

Asset Description

Superannuation

Asset Value

Asset Description

Current Bank Balance

Asset Value

Asset Description

Asset Value

Asset Description

Business Assets

Asset Value

Asset Description

Other Assets
(please indicate type)

Asset Value

Asset Description

Asset Value

Asset Description

FINANCIAL HARDSHIP APPLICATION.

Hardship Questionnaire

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?

4. Please propose how you would like your loan to be varied on account of your financial hardship?

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?

2. What are your household monthly living expenses?

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

4. What are your other assets and their value?

Please attach all supporting documentation below