"*" indicates required fields WARNING Do you really need a loan today?* It can be expensive to borrow small amounts of money and borrowing may not solve your money problems. Check your options before you borrow: For information about other options for managing bills and debts, ring 1800 007 007 from anywhere in Australia to talk to a free and independent financial counsellor Talk to your electricity, gas, phone or water provider to see if you can work out a payment plan If you are on government benefits, ask if you can receive an advance from Centrelink: Phone: 13 17 94 The Government’s MoneySmart website shows you how small amount loans work and suggests other options that may help you. * This statement is an Australian Government requirement under the National Consumer Credit Protection Act 2009. Apply online now or call us on 1300 762 731.Please make sure you fill in all fields marked with an asterix (*) before submitting your application. If you have borrowed from Cash Smart or MiFin before please go to Existing Customers. LoanLoan Amount*$100$150$200$250$300$350$400$450$500$600$700$800$900$1000$1100$1200$1000$1100$1500$1600$1700$1800$1900$2000Loan Purpose*AnniversaryBirthday giftCar regoCar repairsDental expensesEvent ticketsFuneralHoliday costsHome repairsMedical expensesElec / Gas / WaterFuel / TransportPhone / MobileRental bondSchool expensesUtility billsVet billsOther/Multiple – we will contact you to discuss.Your DetailsName* First name Surname Sex*MaleFemaleDate of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ID Type*Drivers Licence18 + CardPassportID Number* Home PhonePlease enter your whole number with no spaces. Mobile PhonePlease enter your whole number with no spaces. Email* Enter Email Confirm Email Your AddressNumber and Street* Suburb/City* State*QueenslandNew South WalesVictoriaTasmaniaSouth AustraliaWestern AustraliaNorthern TerritioryAustralian Capital TerritoryPostcode* Do you...*RentOwnBoardLive With FamilyWorkIs your primary source of income Centrelink or benefits* Yes No Occupation* Employer* Employer Phone*Number and Street Suburb/City* State*QueenslandNew South WalesVictoriaTasmaniaSouth AustraliaWestern AustraliaNorthern TerritioryAustralian Capital TerritoryPostcode Date Job Started*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Pay CycleWeeklyFortnightlyMonthlyType*PermanentTemporaryContractPay Amount* Payday*MondayTuesdayWednesdayThursdayFridaySaturdaySundayMonthlyYour BankBSB* Account Number* Your Budget Details $ Amount Frequency of amountweek/fn/month Income - your main income* *please chooseweeklyfortnightlymonthlyOther Income eg partner contribution* *please chooseweeklyfortnightlymonthlyPersonal loan repayments* *please chooseweeklyfortnightlymonthlyCar loan repayments* *please chooseweeklyfortnightlymonthlyCredit card repayments* *please chooseweeklyfortnightlymonthlyRent or Mortgage or Boarding etc* *please chooseweeklyfortnightlymonthlyFood* *please chooseweeklyfortnightlymonthlyMedical* *please chooseweeklyfortnightlymonthlyOther please chooseweeklyfortnightlymonthlyPlease state "other" Please list 3 emergency contacts: These emergency contacts will only ever be used if we become unable to reach you directly. However, we will check these details against publicly available databases.1*Full NameRelationship. Is my…Mobile PhoneHome/Work Phone2*Full NameRelationship. Is my…Mobile PhoneHome/Work Phone3*Full NameRelationship. Is my…Mobile PhoneHome/Work Phone I have had access to the disclosure documents. I’ve read and understood the Warning about Borrowing and want to proceed with the application. You must tick these boxes first in order to make the “Submit” button appear. If you click either hyperlink above they will open in new pages/tabs. Simply close the new page that opens to come back to this “Apply for a Loan form”.CommentsThis field is for validation purposes and should be left unchanged.