Hardship Request

We are here to assist

We understand that things don’t always go to plan, and when the unexpected occurs our experienced team is here to help.

Completing the financial assistance form will help us understand your financial situation and explore options to assist you during this difficult time.

We encourage you to complete all questions within the form.

Please enter the contract number for the loans/leases that you require assistance. If you have more than one contract, please enter all contract numbers separated by a comma.

Contract Number

Would you like to suspend your direct debit arrangement whilst we assess you for financial assistance?

Yes No

Information about you

Full Name

Date of Birth

Preferred Contact Number

Preferred Email Address

Preferred Contact Method

Phone Email

Marital Status

Single Married De-facto

Number of Dependants

Number of Adults in Your Household

Statement of Financial Position

Reason for Financial Assistance:

Income and Expenses

In the following section you are required to provide details about your income and expenses. To ensure that the information you supply is correctly assessed by our team please indicate the frequency of income and expenses:

Income and Expenses