Apply for financial hardship assistance

ABOUT YOU

Primary applicant:

Title *

First name *

Middle name

Last name *

Date of Birth *

ANZ customer number * ?If you don't know your ANZ customer number please call us on 0800 269 296 or +64 4 470 3142.

Email address*

Confirm email address *

Occupation*

Preferred contact number *

Alternative contact number

Secondary applicant:

Title *

First name *

Middle name

Last name *

Date of Birth *

ANZ customer number * ?If you don't know your ANZ customer number please call us on 0800 269 296 or +64 4 470 3142.

Email address*

Confirm email address *

Occupation*

Preferred contact number *

Alternative contact number

Third applicant:

Title *

First name *

Middle name

Last name *

Date of Birth *

ANZ customer number * ?If you don't know your ANZ customer number please call us on 0800 269 296 or +64 4 470 3142.

Email address*

Confirm email address *

Occupation*

Preferred contact number *

Alternative contact number

Do you have joint accounts or loans?

If you share your banking with another person or business partner, we'll need to know their details too so we can involve them in your application.
(**it's also acceptable if they choose to fill out an application separately**)

Add another applicant

Remove last applicant

If you have people who depend on you financially, please list them below. ?e.g. Children still living at home, elderly parents

Age

Relationship to you

Add another dependant

Remove last dependant

Why are you applying for hardship assistance? *

Please tell us a bit more about your current circumstances, and how your financial situation has changed * (0/600)

Ideally, how do you think we could assist you? * (0/600)

If we are able to assist you, how and when do you think you could get your finances back into shape (for example, if you have been made redundant and you have a new job starting in 6 weeks)? * (0/600)

ABOUT YOU

Primary applicant:

Secondary applicant:

Third applicant:

If you have people who depend on you financially, please list them below. ?e.g. Children still living at home, elderly parents

Why are you applying for hardship assistance? *

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