Re: Zip Co Limited- Hardship Application

Zip Co Limited have received your request for financial hardship assistance.

To properly assess your financial position please complete this financial hardship
application and the statement of financial position (‘SOFP’) and return to
assist@care.zip.co along with your most recent three (3) months bank statements to
verify the information you have provided.

If you have any enquiries do not hesitate to contact our financial hardship team on 02
8294 2345.

Yours sincerely,

Financial Hardship Team

Zip Co Limited

Zip Co Limited • ABN 58 164 440 993

Level 7, 180 George Street, Sydney NSW 2000 • zip.co
Please complete the below questions which form part of your financial hardship
application.

How have your financial circumstances changed since you applied for the Zip Money
facility?
_I have recently had an injury
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What is the reason for financial hardship assistance?

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What changes you can expect in your financial circumstances?

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How much monthly payments can you make towards your Zip Money account/s?
Zip Money - $_________ per month
Zip Pay - $_________ per month

Please explain how and when you expect to resume your regular repayments?
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Zip Co Limited • ABN 58 164 440 993

Level 7, 180 George Street, Sydney NSW 2000 • zip.co
 Statement of Financial Position

Customer Name: Date:

Account No.

Income Details
1st Applicant Weekly Fortnightly Monthly
Unemployment
Family Allowance
Wages/Income
Other (e.g. Rent)

Partner Income Weekly Fortnightly Monthly

Unemployment
Family Allowance
Wages/Income
Other (e.g. Rent)
Other (e,g, int/shares)

Utility Expenses
Weekly Fortnightly Monthly
Gas
Electricity
Water
Council Rates
Internet access
Landline & Mobile Phone
Other

Living Expenses
Weekly Fortnightly Monthly
Childcare/Maintenance
Court judgement/fees
Vehicle Insurance
Home Insurance
Life Insurance
Medical Insurance
Vehicle Registration

Zip Co Limited • ABN 58 164 440 993

Level 7, 180 George Street, Sydney NSW 2000 • zip.co
Rent
School Fees
Vehicle Running Costs
Clothing
Dining out
Entertainment/Holidays
Food / Groceries
Pay TV
Public Transport
Other
Other

Liabilities
Weekly Fortnightly Monthly
First Mortgage
Second Mortgage
Personal Loan
Car Loan
Other Loans
1st Credit Card
2nd Credit Card
Store Card
Other

Zip Co Limited • ABN 58 164 440 993

Level 7, 180 George Street, Sydney NSW 2000 • zip.co