Online Loan Application Form

1Loan Amount Information

2Business Details

3Business Address

4Business Bank Details

5Director's Information

6Declaration

I am applying for*
Loan Amount*
Address of development and reason for loan*
When do you want the loan to start?
DD slash MM slash YYYY
Other Comments

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Business Details
Legal Name*
Trading As
Company Number
Date of Incorporation
DD slash MM slash YYYY
Phone Number*
Phone Number (old)
Email*
Website

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Business Address
Physical Address*
Street Address Address Line 2 City ZIP / Postal Code
Premises*
- Own
- Rent
- Other
How long at this premises?*
No. of Years No. of Months
Postal Address*
Street Address Address Line 2 City Post code
Lawyer's Details
Name of law firm acting for you*
Name of lawyer acting for you
First Last
Lawyer's Postal Address*
Street Address Address Line 2 City ZIP / Postal Code
Lawyer's Phone Number*
Lawyer's Email

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Business Bank Details
Account Name*
Account Number*
Bank*
Branch*
Repayment Frequency*
- Monthly
- On maturity of loan

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Director's and Beneficial Owner's Information
The Anti-Money Laundering and Countering Financing of Terrorism Act 2009 also requires collection of information regarding individuals who are beneficial owners of the company and persons who can act on behalf of the company when a new business relationship is formed with that company.1
If there is more than one Director – Please add all Directors in the company.
1 NOTE: A beneficial owner is an individual who has effective control of a company or who owns more than 25% of that company. Beneficial owners may include shareholders, senior management, such as the CEO, and any other person with effective control, such as some directors. A company can have more than one beneficial owner. You must identify all beneficial owners.

Acting on behalf of the customer is when a person is authorised to carry out transactions or other activities on behalf of the customer. This includes persons who have authority to act on behalf of the business, for example an accountant or persons able to transact on the business account.

If your business is a Trust, or a company owned by a Trust, please tell us - we may need further information in order to meet AML and regulatory requirements

Directors & Beneficial Owners

Name	Date of Birth	Is this person a Director?	Actions

There are no Directors or Beneficial Owners.

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Declaration
As part of the application for a loan, we require certain information and ask you to read and sign the following privacy consent and waiver:
In respect of us providing you a credit facility and undertaking periodic reviews, and for regulatory requirements such as the Anti-Money Laundering and Counter Financing Terrorism Act 2009, you authorise Kings Finance Limited (the Lender) to make credit reference checks and other enquiries within our normal procedures. For this purpose, the Lender may from time to time seek, from any such sources and any credit reporting agency of our choice (“Credit Reporter”), information concerning you.

The Lender confirms that it may need to share information with the third party for that specific purpose, and will collect/share this information in accordance with the Privacy Act 1993.

Credit Reporter: I understand that the Lender is asking me for personal information to use the Credit Reporter’s credit reporting service to carry out a credit check on me. I understand that:
1. The Credit Reporter will give the Lender information about me for that purpose.
2. The Lender will give my personal information to the Credit Reporter, and that the Credit Reporter will hold that information on their system and use it to provide their credit reporting service.
3. When other customers of the Credit Reporter use its credit reporting service, the Credit Reporter may give the information to those customers.
4. The Lender may use the Credit Reporter’s credit reporting services in the future for purposes related to the provision of credit to me. This may include using the Credit Reporter’s monitoring services to receive updates if any of the information held about me changes.
5. If I default in my payment obligations to the Lender, information about that default may be given to the Credit Reporter and the Credit Reporter may give information about my default to its other customers.
Other Sources and holders of information.
1. I further agree that these terms will apply to the provision of finance from the Lender.
2. I consent to the personal information provided in support of the application (whether in this document or otherwise) being held by the Lender and for the information being used from time to time by the Lender for all or any of the following purposes:
  1. For the Lender to decide whether or not to grant a loan to me;
  2. Administering the loan;
  3. Enforcing payment and other legal obligations;
  4. Supplying information to other parties such as debt collection agencies, solicitors, other creditors, government agencies such as the NZ Police or the Department of Internal Affairs, or otherwise if required by law or our statutory auditors.
  5. Supplying me and guarantor(s) with information about services offered by the Lender.
3. I hereby authorise all persons, including credit reporters and other sources as listed above, to provide the Lender and its successors and assigns with such information as they may at any time request about me with respect to items 2(a) to 2(d) above.
4. Further, the Lender may provide personal information about its dealings with me (including any default in my payment obligations to the Lender) to any third party listed in clause 2(d) above in relation to the matters referred to in 2(a) to 2(c) above.
5. Each borrower is aware and agrees specifically that the Lender provide to the guarantor any information used by the Lender which the Lender considers should be provided also to the guarantor
6. I promise that the information given in this application is correct to my best knowledge, information and belief.
We note that I am / we are entitled to request access to, and (if required) correction of, any personal information held about him / her by the lender.

Politically Exposed Persons (PEPs)

PEPs are individuals who are or have been, at any time in the last 12 months, entrusted with prominent public functions in a foreign country e.g. Heads of State or of government, senior politicians, senior government, judicial or military officials, senior executives of state owned corporations, important political party officials. Also - immediate family members of PEPs (spouse, partner, child, parent) or close associates (those sharing ownership of a legal entity or arrangement) are also considered PEPs.
I confirm that I understand this declaration and agree to it. I also understand the definition of PEPs and confirm that neither myself nor any beneficial owner of the loan applicant is a PEP.*
Signed on behalf of:*
Date*
DD slash MM slash YYYY
Checklist

Items that will need to be provided when application is approved:
- Two forms of identification (NZ Driver's License and Passport)
- Verification of Address i.e. Power / Phone Bill (no older than 2 months)
- Company Bank Statement
Email
This field is for validation purposes and should be left unchanged.

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No. of Years	No. of Months

Online Loan Application Form

Business Details

Business Address

Lawyer's Details

Business Bank Details

Director's and Beneficial Owner's Information

Declaration

Checklist