LOAN APPLICATION FORM - Bank South Pacific

LOAN APPLICATION FORM

Dear Customer, Please complete this Applica on Form neatly (by hand) and include all informa on, documenta on and iden fica on required. For enquiries visit your local branch or our website: .pg/Personal/Retail-Banking/Loans/Loans.

Purchase Price:

K

Own Contribu on:

K

CIF Number:

Loan Request:

K

Repayment Offered: K

Fortnightly Monthly

Purpose Of Loan:

Vehicle School/Tui n Household Items Holiday Personal Expenses Housing Other:

PERSONAL DETAILS

First Name:

Middle Name:

Surname:

Birth Date: DD/MM/YY

Gender: M F Marital Status: Single Married De Facto Divorced Widowed

Ages of Children:

Spouse Full Name:

Spouse Birth Date:

Country of Residence:

Residen al Address: (Complete Below)

Sec n/Lot/Street/Suburb:

Date you moved there:

Owner: Self

Rela ves

Country of Ci zenship: Nearest Living Rela ve: (Complete Below) Name & Rela n:

Rental Property Work Address:

Nominated Adminstrator: (for insurance purposes) Name & Rela n:

Work Address: Telephone/Mobile:

Landlord Name: Landlord Address: Previous Residence: Sec n/Lot/Street/Suburb:

Telephone/Mobile: Email:

Email:

Bank:

Acc#

Account Name:

Length of Residency: EMPLOYMENT DETAILS

Applicant

Spouse

Employer: Occupa n: Date Commenced: Employer Address: Work Telephone & Mobile: Previous Employer: Years at Previous Employer:

CREDIT HISTORY (Credit Reference, Previous Loans, Finance Companies, Stores etc. Please a ach Statements)

Ins tu n 1:

Address:

Ins tu n 2:

Address:

Ins tu n 3:

Address:

Have you ever been declared bankrupt, defaulted on a loan or had any judgement or legal proceedings against you? *Yes No *Provide Details:

BSP Personal Loan Applica on Form | Page 1 of 2

STATEMENT OF POSITION

A. Assets ? What you own

House Vehicle Furniture, White Goods Others Bank Account

B. Liabili es ? What you owe BSP Personal/Home Loan Loans: other Lenders Other debts, hire purchase etc Rates/Taxes/ Over Dra Facility

C. Monthly Income Gross Salary (Before Tax) Other Income Provide Details

Monthly Expenses Home Loans Other Loans Motor Vehicle Costs Rent + U i es Insurance, Rates, Taxes School Fees General Living Expenses (Others)

Sec n: Make:

Lot: Model:

Suburb/Street:

Year:

Registra n#:

Primary Account:

Other:

K K K K K Total Assets K

K K K K Total Liabili s K Total Assets ? Liabili s K

Provide 3 Latest Pay slips + Bank Statements

K K K K Total Monthly Income K

K K K K K K K Total Monthly Expenses K Net Surplus K

PERSONAL FINANCIAL AND CREDIT INFORMATION

The undersigned authorises Bank of South Pacific Limited: (

under our arrangements regarding the Foreign Account Tax Compliance Act ("FATCA"). (2) In the event of the undersigned's death, to pay the funeral assistance benefit to the nominated adminstrator specified in this form, subject to the terms and exclusions of the Consumer Credit Insurance Policy. The nominated administrator must be a Natural Person and be at least 18 years of age or over at the time of the application.

The details completed are a true and accurate record:

Applicant Signature:

Date:

Joint Applicant Signature:

Date:

BANK USE ONLY: Branch Officer Name:

Branch:

Date Received: BSP Personal Loan Applica on Form | Page 2 of 2

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