Application Form

It takes less than 3 minutes

Application form is unavailable at this time due to lending software maintenance, please try again at a later date.

Loan Type
Loan Type
- SECURED $501-$20,000
  I have a vehicle that does not have money owing on it or a house with greater than 60% equity.
- UNSECURED $200-$500
  I have good Credit History with no bad debts.
Please tick which type of loan you are applying for.

Loan Type
Loan Details
How much cash do you need?
How much cash do you need?
How much cash do you need?
How much cash do you need?
Paid back over approx
Paid back over approx
Paid back over approx
Paid back over approx
How often can you make these repayments?*
Date of your first repayment*
DD slash MM slash YYYY
Region*
Is there a joint borrower?*
Guarantors
Regretfully due to the additional identification and disclosure requirements for Guarantors, any loan using a Guarantor must be hard copy printed. Government legislation requires that the Guarantor signs the Loan Contract in front of a Lawyer. We’re sorry we can’t offer electronic signing for loans involving Guarantors, however if you think this will be an issue, please call us on 0800 784 252.
Security
All of our loans need a vehicle for security. The value of the security needs to be greater than the amount you borrow and if you're using a vehicle it needs to have a current WOF and registration
What can you use for security on the loan*
All of our loans require a vehicle, boat or real estate for security. We can't use household chattels.
If you don’t have something to offer yourself you could look at using a Guarantor or joint borrower who can offer security to support your application. Give us a call on 0800 784 252 to discuss your options.
Please note: we can only accept motor vehicles from 2000 onwards for security purposes
Vehicle registration plate #*
Make*
Model*
Year*
Is there money owed on the vehicle?*
PLEASE NOTE: THE VALUE OF THE SECURITY (NET OF OUTSTANDING DEBT), MUST BE GREATER THAN THE AMOUNT YOU WISH TO BORROW. ALL VEHICLES USED AS SECURITY MUST ALSO HAVE A CURRENT WOF AND REGO.
How much is owing?*
Hidden
How much is owing on your vehicle?
Secondary Vehicle registration plate #*
Secondary Vehicle Make*
Secondary Vehicle Model*
Secondary Vehicle Year*
Is there money owed on the secondary vehicle?*
ALL OF OUR LOANS NEED A DEBT FREE VEHICLE, REAL ESTATE OR BOAT FOR SECURITY. THE VALUE OF THE SECURITY NEEDS TO BE GREATER THAN THE AMOUNT YOU BORROW AND IF YOU'RE USING A VEHICLE IT NEEDS TO HAVE A CURRENT WOF AND REGISTRATION
Hidden
How much is owing on your vehicle?
Real estate address*
Approximate mortgage balance*
Personal Details
Contact Details
Income/Expenses
Bank Details
$2000 today, repayed at $50.00 per week
Please phone for a custom rate on loans over $10,000

Loan Type
Loan Details
Personal Details
Please complete your first, middle and last name and date of birth exactly as they appear on your Licence, Passport or other ID.
Title*
First Name*
Middle Name
Surname*
Date of birth (dd/mm/yyyy)*
DD slash MM slash YYYY
Gender*
Occupation*
Employer*
Employment status*
Length of employment*
How many children are in your care?*
Identification
Are you a New Zealand resident*
Type of photo ID*
Driver licence number (5a)*
Version number (5b)*
Passport number*
Passport Issue date*
DD slash MM slash YYYY
Passport expiry date*
DD slash MM slash YYYY
* We will require a copy of this ID (scanned or photo from your phone) to be emailed to apply@qcf.co.nz
Joint Applicant - Personal Details
Joint Applicant's title*
Joint Applicant’s first name*
Joint Applicant’s middle name*
Joint Applicant’s surname*
Joint Applicant’s date of birth (dd/mm/yyyy)*
DD slash MM slash YYYY
Joint Applicant’s marital status*
Joint Applicant’s gender*
Joint Applicant’s occupation*
Joint Applicant’s employer*
Joint Applicant’s employment status*
Joint Applicant’s length of employment*
How many dependants does the Joint Applicant support?*
Joint Applicant’s street number and name*
Joint Applicant’s suburb*
Joint Applicant’s city/region*
Joint Applicant's postcode*
Joint Applicant's time at address:*
Joint Applicant’s residence type*
Joint Applicant’s mobile phone number*
Hidden
Joint Applicant’s mobile phone number
Joint Applicant’s mobile phone number*
Joint Applicant’s email address*
Joint Applicant’s home phone number (landline)
Hidden
Joint Applicant’s home phone number (landline)
Joint Applicant’s home phone number (landline)
Joint Applicant’s work phone number (landline)
Hidden
Joint Applicant’s work phone number (landline)
Joint Applicant’s work phone number (landline)
Joint Applicant - Identification
Is the Joint Applicant a New Zealand citizen*
Joint Applicant’s type of photo ID*
Joint Applicant’s driver licence number (5a)*
Joint Applicant’s version number (5b)*
Joint Applicant’s passport number*
Joint Applicant's passport issue date*
DD slash MM slash YYYY
Joint Applicant's passport expiry date*
DD slash MM slash YYYY
Joint Applicant’s firearms licence*
* We will require a copy of this ID (scanned or photo from your phone) to be emailed to apply@qcf.co.nz
Guarantor - Personal Details
Guarantor’s title*
Guarantor’s first name*
Guarantor’s middle name*
Guarantor’s surname*
Guarantor’s date of birth (dd/mm/yyyy)*
DD slash MM slash YYYY
Guarantor’s gender*
Guarantor’s marital status*
Guarantor’s occupation*
Guarantor’s employer*
Guarantor’s employment status*
Guarantor’s length of employment*
How many dependants does the guarantor support?*
Guarantor’s street number and name*
Guarantor’s suburb*
Guarantor’s city/region*
Guarantor's postcode*
Guarantor’s time at address:*
Guarantor’s residence type*
Guarantor’s mobile phone number*
Hidden
Guarantor’s mobile phone number
Guarantor’s mobile phone number*
Guarantor’s email address*
Guarantor’s home phone number (landline)
Hidden
Guarantor’s home phone number (landline)
Guarantor’s home phone number (landline)
Guarantor’s work phone number (landline)
Hidden
Guarantor’s work phone number (landline)
Guarantor’s work phone number (landline)
Guarantor - Identification
Is the guarantor a New Zealand citizen*
Guarantor’s type of photo ID*
Guarantor’s driver licence number (5a)*
Guarantor’s version number (5b)*
Guarantor’s passport number*
Guarantor’s passport expiry date*
DD slash MM slash YYYY
Guarantor’s firearms licence*
* We will require a copy of this ID (scanned or photo from your phone) to be emailed to apply@qcf.co.nz
Joint Applicants and Guarantors must be New Zealand Citizens
Contact Details
Income/Expenses
Bank Details
$2000 today, repayed at $50.00 per week
Please phone for a custom rate on loans over $10,000

Application Form

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