HOME LOAN APPLICATION

Who is this application for?

For me only For me and another person For a company For a trust

Complete all sections except sections 3, 4 and 5 Complete all sections except sections 4 and 5 Complete all sections Complete all sections

D D M M Y Y Y Y Today’s date

What’s your name, date of birth and gender?

Mr Mrs Miss Ms Other First names

Last name

D D M M Y Y Y Y Date of birth Male Female

If you’re an existing customer, what’s your access number?

What are your phone numbers and email address?

Work [ ] ^{Mobile [ ]}

Home [ ] ^{Fax [ ]}

Email

What’s your relationship status?

Single Couple Other

How many dependants do you have and how old are they?

dependants aged

Are you a permanent New Zealand resident?

Yes No, I’m a resident of

What is your country of birth?

What is your country of citizenship?

Where do you live, and how long have you lived there?

In my own home I rent With relatives

I board In accommodation provided by my employer Address

for years and months

If you have a different postal address, what is it?

Address

If you have lived at your current address for less than 2 years, what was your previous address, and how long did you live there?

Address

for years and months

Who do you currently work for, and how long have you worked there?

Name Address

What’s your name, date of birth and gender?

Mr Mrs Miss Ms Other First names

Last name

D D M M Y Y Y Y Date of birth Male Female

If you’re an existing customer, what’s your access number?

What are your phone numbers and email address?

Work [ ] ^{Mobile [ ]}

Home [ ] ^{Fax [ ]}

Email

What’s your relationship status?

Single Couple Other

How many dependants do you have and how old are they?

dependants aged

Are you a permanent New Zealand resident?

Yes No, I’m a resident of

What is your country of birth?

What is your country of citizenship?

Where do you live, and how long have you lived there?

In my own home I rent With relatives

I board In accommodation provided by my employer Address

for years and months

If you have a different postal address, what is it?

Address

If you have lived at your current address for less than 2 years, what was your previous address, and how long did you live there?

Address

for years and months

Who do you currently work for, and how long have you worked there?

Name Address

3. About the other applicant 1. Getting started

(Bank use only) Application number

2. About you

Please print your details clearly in CAPITAL letters, using a pen

HOME LOAN APPLICATION

1. DIRECTOR, SHAREHOLDER OR TRUSTEE What is your designation?

Professional/Independent?

Yes No

What’s your name, date of birth and gender?

Mr Mrs Miss Ms Other First names

Last name

D D M M Y Y Y Y Date of birth Male Female

What are your phone numbers and email address?

Work [ ] ^{Mobile [ ]}

Home [ ] ^{Fax [ ]}

Email

What is your country of birth?

What is your country of citizenship?

What is your occupation?

2. DIRECTOR, SHAREHOLDER OR TRUSTEE What is your designation?

Professional/Independent?

Yes No

What’s your name, date of birth and gender?

Mr Mrs Miss Ms Other First names

Last name

D D M M Y Y Y Y Date of birth Male Female

What are your phone numbers and email address?

Work [ ] ^{Mobile [ ]}

Home [ ] ^{Fax [ ]}

Email

What is your country of birth?

What is your country of citizenship?

What is your occupation?

3. DIRECTOR, SHAREHOLDER OR TRUSTEE What is your designation?

Professional/Independent?

Yes No

What’s your name, date of birth and gender?

Mr Mrs Miss Ms Other First names

Last name

D D M M Y Y Y Y Date of birth Male Female

What are your phone numbers and email address?

Work [ ] ^{Mobile [ ]}

Home [ ] ^{Fax [ ]}

Email

What is your country of birth?

What is your country of citizenship?

What is your occupation?

4. DIRECTOR, SHAREHOLDER OR TRUSTEE What is your designation?

Professional/Independent?

Yes No

What’s your name, date of birth and gender?

Mr Mrs Miss Ms Other First names

Last name

D D M M Y Y Y Y Date of birth Male Female

What are your phone numbers and email address?

Work [ ] ^{Mobile [ ]}

Home [ ] ^{Fax [ ]}

Email

What is your country of birth?

What is your country of citizenship?

What is your occupation?

4. Director, Shareholder and Trustee details

This section must be completed by all individuals listed below who are not applicants:

• Limited liability company: All shareholders who own more than 25%, the CEO and all directors

• Trust: All trustees

6. Your income

If you’re guaranteeing another facility/loan (including Trusts and Look Through Companies) please provide details in sections 5 and 6.

If this application is just for you, enter your individual details. If it’s for you and another person, enter your combined details.

What home or investment properties do you own?

Type Address Value

$

$

What motor vehicles do you own?

Make Model Registration Value

$

$

What savings and investment accounts do you have?

Bank or organisation Type Balance

$

$

What superannuation do you have?

Bank or organisation Type Value

$

What other assets or investments do you have?

Type Value

$

7. Your savings and investments

TRUST DETAILS Trust name

Trust address

If a Charitable Trust, what are the objects of your Trust?

What is the source of wealth or funds of your Trust?

If your Trust has 10 or less named beneficiaries, list them below

1.

D D M M Y Y Y Y Date of birth

2.

D D M M Y Y Y Y Date of birth

3.

D D M M Y Y Y Y Date of birth

4.

D D M M Y Y Y Y Date of birth

5.

D D M M Y Y Y Y Date of birth

6.

D D M M Y Y Y Y Date of birth

7.

D D M M Y Y Y Y Date of birth

8.

D D M M Y Y Y Y Date of birth

9.

D D M M Y Y Y Y Date of birth

10.

D D M M Y Y Y Y Date of birth

Otherwise list the classes of beneficiaries of your Trust:

COMPANY DETAILS Company name

Registered address

Does your company have nominee shareholders or shares in bearer form?

Yes No

If Yes, what is the source of wealth or funds of your company?

5. Trust and company details

How much money do you earn each year, before tax?

$ in base income

excluding overtime or commission

$ from other employment

e.g. second job, casual work Job

$ from other income

e.g. overtime, commission, interest, allowances

$ in profit before tax

for self-employed applicants only

$ A Total

If this application is for you and another person, what’s their main source of income?

Full-time work Self-employment ACC

Permanent part-time work Contract work WINZ

Other e.g. seasonal work, retired

How much money do they earn each year, before tax?

$ in base income

excluding overtime or commission

$ from other employment

e.g. second job, casual work Job

$ from other income

e.g. overtime, commission, interest, allowances

$ in profit before tax

for self-employed applicants only

$ B Total

What’s your combined income from investment properties each year, before tax?

$ C Total

What’s your total income?

$ A

+

+

6. Your income continued

If this application is just for you, enter your individual details. If it’s for you and another person, enter your combined details.

How much do you owe? How much do you spend? Tick if this expense will

Bank or organisation Credit limit Balance Monthly stop after the loan is drawn

$ $ in home loans $ in repayments Yes

$ $ $ Yes

$ $ in personal loans $ in repayments Yes

$ $ in overdrafts $ in repayments Yes

$ $ $ Yes

$ $ in credit or store cards $ in repayments Yes

$ $ $ Yes

$ $ $ Yes

$ $ in hire purchases $ in repayments

Yes

$ $ $ Yes

$ $ $ Yes

^$ on a student loan $ in repayments Yes

$ $ in other loans $ in repayments Yes

^{$ Total $} on rent or board Yes

^$ on family support or child care costs

^$ on other expenses Yes

^{$ Total} Your initials

8. Your loans and spending

What would you like to do?

Buy a property Refinance

What will you spend the loan on?

A residential property An investment property

An apartment A holiday home

Construction/New dwelling Major alterations Minor alterations (e.g. non-structural/interior/exterior decorating)

Vacant land Debt consolidation

Personal assets Lifestyle

A holiday Other Security address

When do you need this loan by?

D D M M Y Y Y Y Date

How do you want your loan to be structured?

Interest-only period Amount Preferred

Portion Fixed period (maximum 3 years) Interest rate * (minimum $10,000) repayment amount Fixed rate lock option

Variable ^Years % Per annum $ $

Fixed A Years Years % Per annum $ $ ^{Yes No}

Fixed B Years Years % Per annum $ $ ^{Yes No}

Fixed C Years Years % Per annum $ $ ^{Yes No}

Revolving % Per annum $ $

^{$ Total}

How much is the property and how much do you need to borrow?

$ D Property price or value

$ E Deposit

$ D

-

When would you like your repayments to begin?

D D M M Y Y Y Y Date

How frequently would you like to make your repayments?

Weekly Fortnightly Monthly

How long do you want to repay the loan?

Years (maximum 30)

Would you like an overdraft?

Yes, $500 Yes, $1,000 Yes, $2,000 No thanks

9. Your home loan options

* Rates at date of application.

Rates are subject to change unless fixed rate lock option has been taken.

DECLARATION – HOME LOANS ONLY

I/WE confirm that all of the information in this application is true and correct. I/We will notify Kiwibank Limited (Kiwibank) immediately if there is any change in any information given in this application.

I/WE acknowledge that the provision of driver licence information is voluntary, but that if I/we do not provide this information, Kiwibank may not offer me/us a home loan.

I/WE acknowledge that Kiwibank will collect and use the information set out in this application to assess whether to offer me/us a home loan. Kiwibank will hold the information securely and will only use it in developing and running Kiwibank. If I/we ask Kiwibank not to provide me/

us with this information, Kiwibank will comply with my/our request. I/We may ask Kiwibank to show me/us the information it holds about me/us and to make corrections to it.

I/WE agree that Kiwibank or any authorised agent of Kiwibank may Who’s your existing house and contents insurer?

Name

How much life insurance cover do you have?

$ You $ Other applicant

How much do you spend on income protection per month?

$ You $ Other applicant

Proof of identity Option 1

Provide one of:

• Passport

• NZ certificate of identity

• NZ refugee travel document

• NZ emergency travel document

• NZ firearms licence

Option 2

Provide one of:

• NZ driver licence And one of:

• Other NZ bank’s card with customer name and signature

• Other NZ bank statement issued in the preceding 12 months

• SuperGold Card

• Community Services Card

• NZ Government statement (e.g. IRD, WINZ, Studylink) with customer name issued in the preceding 12 months

Option 3

Provide one of:

• Full NZ birth certificate

• Certificate of NZ citizenship And one of:

• NZ driver licence

• NZ defence force photo ID

• NZ police photo ID

• 18+ Card

• NZ student photo ID

Proof of residential address

Provide one of the following issued in the last 12 months:

• NZ Bank statement issued within the last 12 months

• Utilities bill (including rates bill)

• Tenancy Agreement

• Employment Agreement

• Letter from school or tertiary institute

• Letter from GP

• Store account statement

What’s the name and address of your solicitor?

Name Firm Address

What’s their phone number, fax number and email address?

Phone [ ] ^{Fax [ ]}

Email

Will any part of your home loan be used for construction?

Yes, it will cost $ No

If some or all of the loan will be used for construction please complete this section.

Are you going to be living in the property once it has been completed?

Yes No

Is the development contract for a fixed price?

Yes No

Is the development by a registered master/certified builder?

Yes No

How long is construction scheduled to take? Months

Loan completed by

Employee

I confirm I have physically identified the customer(s), and I have verified their address, income, employment, assets and liabilities and retained copies of the identification.

Employee signature

D D M M Y Y Y Y Today’s Date

10. Your loan and construction

11. Your solicitor

12. Your current insurance

Heartland Bank use only

13. Your identification

Declaration

Your initials Get house insurance

Kiwibank and Heartland Bank require your house to be insured before you can drawdown any home lending. We can contact you on approval of your loan application to arrange house insurance easily over the phone.

Yes, I’d/we’d like to be contacted about house insurance, please arrange for someone to contact me/us.

Get loan insurance

Loan insurance isn’t compulsory. However, we strongly recommend your loan is protected in the event that you can’t meet your loan repayments due to your death or disablement. Please tick one of the two options.

Yes, I’m/we’re interested in finding out more about loan insurance. Please arrange for someone to contact me/us when my/our loan application is approved.

No, I’m not/we’re not interested in loan insurance. Your initials Lender’s Mortgage Insurance

If you take out a Kiwibank Home Loan and Kiwibank require the home loan to be insured under a Lender’s Mortgage Insurance policy, you’ll be told. You’ll be required to pay the premium for this.

This home loan application is for a home loan provided by Kiwibank and arranged by Heartland Bank. If you want information in respect of this application, you should contact Heartland Bank in the first instance.

Kiwibank’s arrangements with Heartland Bank mean that unless Kiwibank provides you other accounts and services, you do not have access to debit cards or phone, mobile or internet banking in respect of your home loan. Heartland Bank may receive a commission for referring a home loan to Kiwibank.

14. Insurance

15. Loan Application

16. Finishing up

I/WE acknowledge that Kiwibank’s lender’s mortgage insurer will collect and use the information set out in this application to assess whether to provide Kiwibank lender’s mortgage insurance in respect of my/our home loan and for recovery or other business related purposes. Kiwibank’s lender’s mortgage insurer will hold the information securely. I/We may ask Kiwibank’s lender’s mortgage insurer to show me/us the information it holds about me/us and to make corrections to it. I/We agree that Kiwibank’s lender’s mortgage insurer may collect information from any person who can provide information that is of relevance to it.

I/WE acknowledge that Kiwibank’s lender’s mortgage insurer may disclose my/our information to its related companies (whether in New Zealand or overseas), reinsurers, external advisers, third parties for the purposes of fraud prevention and detection, credit providers (including but not only in relation to fine status queries), payment systems operators, other financial institutions, contractors, agents, mercantile agents and other service providers, my/our referees (including my employer and my/our legal and financial advisors), a guarantor or potential guarantor, Kiwibank, rating agencies, government and other regulatory bodies.

I/WE understand that Kiwibank and/or Kiwibank’s lender’s mortgage insurer will credit check me/us. As part of that credit check, Kiwibank and/or the lender’s mortgage insurer will give my/our information to credit reporting agencies, and credit reporting agencies will give my/

our information to Kiwibank and/or the lender’s mortgage insurer. Credit reporting agencies will use the information provided by Kiwibank and/or the lender’s mortgage insurer to update their credit reporting databases.

When other parties use the credit reporting agencies’ services, they will be provided my/our updated information. Kiwibank and/or the lender’s mortgage insurer might use credit reporting agencies’ services in the future for purposes related to the provision of credit. For example, Kiwibank and/or the lender’s mortgage insurer may use credit reporting agencies’ monitoring services to receive updates if any of the information held about me/us changes. If I/we default in my/our payment obligations to Kiwibank and/or the lender’s mortgage insurer, the default information will be listed on the credit reporting agencies’ databases and will therefore be disclosed to other parties when they use the credit reporting agencies’ services.

I/WE acknowledge that Kiwibank’s Home Loan Terms and Conditions are available at www.kiwibank.co.nz.

I/WE acknowledge that information about me/us may also be collected and held by Heartland, its related entities, successors, assigns, agents and associates (the Heartland Group). The information may be used by the Heartland Group to develop and run its business, including administering and monitoring products or services provided to me/us (or any related entity), and providing me/us with information about other products or services, including those of selected third parties. For the above purposes, the Heartland Group may provide and obtain information about me/us to or from other organisations or people the Heartland Group considers appropriate, including its service providers, other financial and insurance institutions (including Kiwibank), government departments, and my/our employer/accountant. The Heartland Group may use the services of credit reporting agencies on an ongoing basis for purposes relating to the provision of credit to me/us (or any related entity), and may exchange information about me/us with those agencies, including default information. Those agencies may retain that information and provide that information to other customers who use their credit reporting services. I/

we may request the full details of every organisation or person to whom the Heartland Group has disclosed information about me/us. Individuals have rights to access and request correction of their personal information under the Privacy Act 1993.

Kiwibank is responsible for sending me/us certain information required by any law. Kiwibank calls these disclosures. By applying for this Home Loan and any overdraft, I/we each:

• consent to Kiwibank emailing me/us information about my/our Home Loan and any overdraft, including the terms and conditions of my/our Home Loan and overdraft (and, in each case, any other Home Loan or overdraft I/we get with Kiwibank in the future)

• consent to Kiwibank making disclosures or giving notices under any law to me/us in electronic form by email, or by emailing me us a website link

• consent to Kiwibank and any provider of house or loan insurance I/we arrange through Kiwibank emailing me/us about my/our application for that insurance, its terms and conditions and any notices and information about it (and, in each case, any such insurance I/we arrange through Kiwibank in the future)

I/WE acknowledge that Kiwibank will send the emails described above to the email address I/we’ve given in this application (or any email address I/

we give Kiwibank in the future).

For joint applicants only

If I’m a joint applicant who has not given an email address in this application, I specify that my disclosures and the other things described above can be made available to the other applicant (on my behalf) at the email address they’ve given in this application (or any email address they give Kiwibank in the future).

Marketing messages

I/WE acknowledge that Kiwibank can communicate marketing or promotional messages to me/us electronically and understand that those messages will include an unsubscribe option. I/we will need to unsubscribe with Kiwibank if I/we don’t want to receive those emails.

Welcome Home Loan

If I am/we are applying for a Welcome Home Loan, I/we consent to Heartland giving my/our information to Housing New Zealand Corporation in order to assess the application, to determine whether I am/we are a past or present Housing New Zealand Limited tenant that owes a debt to the Crown, and for operating the Welcome Home Loan programme.

I/we confirm that:

• I/We do not already own a home;

• I/We will live in the home purchased or built using the Welcome Home Loan; and

• I/We will not use the Welcome Home Loan to purchase an investment property or for refinancing.

My signature

Other applicant’s signature

D D M M Y Y Y Y Today’s date

16. Finishing up continued