Tertiary and Graduate overdraft
and credit card application form
Kiwibank Limited, Private Bag 39888, Wellington 5045
1. Before you start Fill in your details using CAPITAL letters.
Eligibility – to apply for an Overdraft or Credit Card under the Tertiary or Graduate Packs, you must:
1. Be 18 years of age or older
2. Be a New Zealand permanent resident
3. Have any income you receive (if any), such as student loan, student allowance, salary / wages credited / paid directed into your Kiwibank account
4. Have a good credit history
We’ll conduct a credit check and assess you for a credit limit based on your financial circumstances.
I am applying for:
Tertiary Graduate
Tertiary
Graduate
Are you studying at a New Zealand University, Polytech, Industry Training Organisation
or NZQA approved place of study for a minimum of one year?
Have you successfully completed full or part-time study at a New Zealand University,
Polytech, Industry Training Organisation or an NZQA approved place of study for
a minimum of one year?
Yes No
If you haven’t already, you’ll need to provide Kiwibank with:
Proof of enrolment status – Letter of acceptance to your course, Student ID, or receipt/
invoice of fees to show enrolment in a NZQA course for a minimum of one year.
If you don’t already have a Kiwibank account you will also need to bring:
Passport or Driver’s licence and a debit or credit card with your name embossed.
A bank statement or utility bill (no more than 6 months old) printed with your name
and address.
Yes No
If you haven’t already, you’ll need to provide Kiwibank with:
Proof that you’re a graduate – academic record or letter confirmation
of course completion.
If you don’t already have a Kiwibank account you will also need to bring:
A Passport or Driver’s licence and a debit or credit card with your name embossed.
A bank statement or utility bill (no more than 6 months old) printed with your name
and address.
2. Overdraft application details
Kiwibank overdrafts are designed to help you manage gaps between outgoing costs and when your income comes in, or for use as a backstop facility to
cover smaller unexpected expenses or purchases. A description of the overdraft product and alternative options can be found at kiwibank.co.nz
Do you want an overdraft: Yes I would like to apply for a limit of: No
(Mandatory)
$
Please note that $2,000 is the maximum limit available under the Tertiary and Graduate Packs ($1,000 for the first year on the Tertiary Pack).
The overdraft will be accessible from your account that has income credited/paid into it, (Now, Front Runner, Free Up and Bill Blaster only).
3
8
Bank
Branch number
Account number
Suffix
3. Credit Card application details
Kiwibank credit cards are designed to be used for short term borrowing, but they can be an expensive way to borrow large amounts over a long period. You
can find more details about our credit card products and alternative options at kiwibank.co.nz.
Do you want a credit card? Yes I would like to apply for a limit of: No
$
(Mandatory)
The name printed on your card will be your first name and surname.
Up to a maximum of $500 ($1000 on Graduate Pack).
If you’d prefer your first initial and surname, please tick here 4. Nature and purpose of relationship with Kiwibank
What’s your main reason for joining Kiwibank? (Select all that apply)
For everyday transaction services e.g. receiving salary, paying bills
To secure funds for the purchase of an asset To access funds for unexpected expenses
To send and receive money internationally
5. About you
What’s your name, date of birth and gender?
Mr Mrs Miss Ms What are your phone numbers and email address?
These are the main ways we will communicate with you. See section 9 for details on how we will send you key information.
Other
First names
Work 0
Last name
Date of birth Male Mob 0 2
D
D
M
M
Y
Y
Y
Y
Female
Are you already a Kiwibank customer? What’s your customer access number?
Home 0
Email (mandatory)
Kiwibank may send marketing messages by email or text.
Street address
Suburb
Town or city
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Postcode 5. About you (cont.)
8. Credit Card Repayment Insurance
What’s your postal address?
The same as my residential address
What is it?
Credit Card Repayment Insurance helps you repay your Kiwibank Credit
Card if something unexpected happens to you or any joint account holder.
Life events covered:
•• Death
•• Critical illness
•• Temporary or permanent disablement
•• Redundancy (if you’re employed)
•• Bankruptcy ( if you’re self-employed)
The address below
Street address
Suburb
Postcode Town or city
Are you employed?
Yes, full-time
Yes, part-time
Yes, self-employed
No, unemployed
No, retired
Other
6. Your alternative contact
In case we need to contact you and you’re not available, please provide
details of a relative or close friend not living at the same address as you.
Name
What’s their relationship to you?
Relationship
What are their phone numbers and email address?
Mob 0 2
Home 0
Email
7. Your financial position
We’ll use the following information to assess your eligibility for a Kiwibank
Credit Card and/or overdraft.
What’s the value of the things you own?
Cash and savings (including Term Deposits)
$
Home and investment property (market value)
$
Other investments (e.g. KiwiSaver, other superannuation, shares)
$
Other things you own (e.g. car, boat)
$
Credit Card Repayment Insurance can be included with your
Credit Card Application.
I would like to apply for Credit Card Repayment Insurance.
$
Home and property loans
$
Student loan
$
Other loans and hire purchases
$
1.Important Terms, conditions and exclusions, which are set out in the
Credit Card Repayment Insurance policy wording and policy schedule will
be emailed to you. A copy of the policy wording is also available at
Kiwibank.co.nz.
2.Credit Card Repayment Insurance is provided by Kiwi Insurance Limited
and Kiwi Insurance Limited is solely responsible for any claims under
this policy. Kiwibank does not guarantee the obligations of, or any
products provided by Kiwi Insurance Limited. Kiwibank may receive a
commission on any policy it arranges.
What’s your annual personal income before tax?
(includes salary, rent, student allowance, etc)
$
From you
Other than salary or wages, do you receive funds from any of these industries?
Antique dealer
Jeweller
Provision of money remittance services Pawn broking
Weapon or firearm dealer or manufacturer Unregistered charities
Company formation agent Bullion or precious metal dealer
Provision of foreign exchange services Casino or lottery and gambling operations
Virtual currencies e.g. Bitcoin None of the above
Other contributors
Yes Is there anyone else who helps pay your monthly expenses?
Their annual income before tax
Their relationship to you
No
$
Spouse Partner
How much do you spend each month on:
Rent, board and/or home loan payments
$
Other loans and hire purchases
$
Do you have any other credit cards/store cards?
Yes How many other credit cards/store card(s) do you have?
What’s the total amount you owe on all your credit cards/store card(s)?
$
What’s the total combined limit of your credit card(s)/store card(s)?
$
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Yes
Ticked ‘yes’? – Great, Kiwi Insurance will send you an email with all the relevant
policy documents. Just keep these in a safe place, and that’s all from your end.
How much money have you borrowed on:
Overdrafts
It’s handy to know that Credit Card Repayment Insurance covers joint
cardholders at no extra charge.
Terms, conditions and exclusions are set out in the policy wording but some
key information is:
1.There are certain exclusions that apply to the cover. For example, a claim
arising from any medical condition which existed on or prior to the Start
Date of Insurance is considered an exclusion.
2.Claims arising from redundancy or indication of redundancy prior to
the Start Date of Insurance or within 90 days after the Start Date of
Insurance are not covered.
3.To claim for temporary or permanent disablement, redundancy or
bankruptcy, you must be in paid employment with a single employer or
self-employed for at least 25 hours per week and meet the other criteria
set out in the policy wording.
Please note you must be aged between 18 and 64 at the time of application
to be eligible for cover. Cover for all benefits except death ends at age 65.
Cover for death ends at age 75.
How much will it cost?
Premiums are charged to your Kiwibank credit card account automatically
every month.
It costs 75 cents for every $100 (or part thereof) of your closing balance
at the monthly statement date.
No
9. Terms and conditions
11. Your personal information
I acknowledge that the terms and conditions for my overdraft and/or the
Low Rate MasterCard® are available online at
kiwibank.co.nz/about-us/legal-docs
I acknowledge that if the application is accepted, those terms and conditions
will take effect from the time my card or card account is first used and/or the
overdraft is loaded and accessible from my nominated account.
Information is true
I confirm that all of the information in this application is true and correct. I will
notify Kiwibank immediately if there is any change in any information given in
this application.
10. Communicating with you
Receiving your Terms, credit card statements and disclosures
Your credit card statements will be available to you through internet
banking.
If you wish, you can choose to have your credit card statements delivered
through email or post and this can be requested once your account is set up.
By applying for this overdraft and/or credit card, you:
•• consent to Kiwibank emailing you about this application, the terms
and conditions of your overdraft or credit card and notices about your
overdraft or credit card (and, in each case, any other overdraft or credit
card you get with us in the future)
•• consent to Kiwibank making disclosures or giving notices under the
Credit Contracts and Consumer Finance Act 2003 or any other law to you
in electronic form by email, or by emailing you a website link, or within
Kiwibank internet banking (including by Securemail message or by
sending you a Securemail message with a website link). Kiwibank calls
these “Disclosures”
•• consent to Kiwibank emailing you notifications when your credit card
statements are available in internet banking for this credit card and any
future credit cards you have with Kiwibank
•• consent to Kiwibank emailing your credit card statements for this credit
card and any future credit cards you have with Kiwibank to you in
electronic form
So that you can access your credit card statements for this credit card and
any future credit cards you have with Kiwibank, you:
•• acknowledge that Kiwibank requires you to register for internet banking
•• agree to register for internet banking, if you’re not already registered
•• consent to your credit card statements being made available to you
through Kiwibank internet banking
You acknowledge that Kiwibank will send the emails described above to the email address you’ve specified in your application (or any other email
address you provide to Kiwibank in the future).
Use of personal information
I authorise Kiwibank to deal with my personal information in accordance
with the Kiwibank General Terms and Conditions, available online at kiwibank.co.nz or at my local Kiwibank.
I have read and understood those terms and conditions and in particular
acknowledge that:
•• Kiwibank can collect personal information about me for the purposes
described in those terms and conditions, from any person who can
provide Kiwibank with that information.
•• When Kiwibank and/or its third party suppliers collect personal
information about me, I authorise disclosure of that information between
Kiwibank and its third party suppliers, for the purpose of assisting
Kiwibank to procure and administer the provision of services to me.
Kiwibank can send me marketing or promotional messages (including
electronic messages) about products and services that it thinks might be
of interest to me (including from its selected business partners).
Where these messages are electronic, I can stop receiving them by using
the unsubscribe facility included in each message. Where these messages
are not electronic, I can ask Kiwibank to stop sending them, and Kiwibank
will comply with that request as soon as reasonably practicable.
Kiwibank credit checking and reporting
I understand that Kiwibank may credit check me. As part of that credit
check, Kiwibank may give my information to credit reporting agencies, and
credit reporting agencies may give my information to Kiwibank. Kiwibank
may also provide information on my repayment history (including both
positive and negative repayment history) and any defaults on my payment
obligations to Kiwibank to credit reporting agencies. Credit reporting
agencies may use the information provided by Kiwibank to update their
credit reporting databases. When other parties use the credit reporting
agencies’ services, they may be provided with my updated information.
Kiwibank may also use credit reporting agencies’ services in the future. For
example, Kiwibank may use credit reporting agencies’ monitoring services
to obtain updates if any of the information that a credit reporting agency
holds about me has changed.
I agree with sections 7 (where applicable) and 8-10 above
My Signature
Date D
D
M
M
Y
Y
Y
Y
Take it to your local Kiwibank or place your application in an envelope and post it to us free of charge to: Kiwibank Limited, Freepost 161688, PO Box 39888, Wellington 5040
Bank Use Only
Identification provided by the applicant
Type
Expires
D
D
M
M
Y
Y
Y
Y
Type
Expires
D
D
M
M
Y
Y
Y
Y
Number
Issued
D
D
M
M
Y
Y
Y
Y
Number
Issued
D
D
M
M
Y
Y
Y
Y
Version
Issuer (Country/Entity)
Version
Issuer (Country/Entity)
Special instructions
Accepted by
Staff member’s name
Received by
PostShop name/PBU number
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Bank Stamp
RESET form
FM3290 JUL16