Client Application Form (NZ)

Client Application Form

Thank you for your applying with JustFund. Please complete the below form to commence your application.
Your First Name*
Your Middle Name*
Your Last Name*
Your Contact Number*
Your Contact Number
Can we contact you on this number?*

YesNo
Your Email Address*
Your Date Of Birth*

DayMonthYear
Your gender*
Your residential address*

Street Address

Street Address Line 2

Suburb/TownState / Province

Post Code
Have you ever been known by any other name?*

YesNo
Your Former First Name(s)
Your Former Middle Name(s)
Your Former Last Name(s)
Are you currently working with a law firm or barrister?*

YesNo

Your Law Firm's Details
What's the name of the law firm or barrister that you're working with?
Your Lawyer's First Name*
Your Lawyer's Last Name
Your Lawyer's Email Address
Have you ever previously engaged a different law firm to assist you in this family law matter?

YesNo
What's the name of your former law firm?
To process your application, we need to request certain information from your lawyer. This information is really important and can help to shortcut the application process. Do you consent to us requesting information and documents from your law firm and your law firm providing documents and information to us?*

I confirm.

Your Former Partner's Details
Your Former Partner's First Name *
Your Former Partner's Middle Name *
Your Former Partner's Last Name *
Your Former Partner's Date Of Birth *

DayMonthYear
Your former partner's gender*
Has your former partner ever been known by any other name?*

YesNo
Their former first name(s)
Their former middle name(s)
Their former last name(s)

Your Relationship
What is the approximate value of the total asset pool to be divided between you you and/or your former partner (excluding superannuation)?
Do you and your former partner own any real property? (E.g. apartment, house etc)*

YesNo
Are you the registered legal owner of any real property? (E.g. you own the property yourself or you own it jointly with someone else)

Yes, my name is on title of property.No, the property is not registered in my name.
How many years did you live with your former partner?
Did you your former partner enter into any kind of Contracting Out Agreement, Section 21A Agreement or other kind of "prenuptial agreement"?*

YesNo

Your Legal Matter
What issues are in dispute between you and your former partner? (select all that may apply)*

Relationship propertyCare of childrenFamily violenceSpousal maintenanceTrust claimsOther
Have legal proceedings commenced in relation to relationship property matters?*

YesNoUnsure

Funding Amount
What amount of funding are you applying for?*
Approximately much have you already paid in legal costs to date?*
Approximately much (if any) do you currently have outstanding/owing to your law firm?*
JustFund provides a flexible funding solution that allows clients to repay JustFund from the proceeds they receive from their legal matter. It is important that you consider the outcome you would like to achieve in your legal matter and how your will access funds to repay JustFund. To make sure that JustFund is the right fit for your circumstances and objectives, please describe how you intend to repay JustFund e.g. from funds from sale of property, settlement payment from your former partner etc. *

Your nearly there! This is the final page!
It's really important that you receive and review important disclosures from JustFund regarding your loan. Please review and confirm the below to provide for JustFund to send these disclosures to you by email.
You consent to receiving disclosure statements required by the Credit Contracts and Consumer Finance Act 2003 (including any disclosure required by that Act before you enter into a Funding Agreement with JustFund) in electronic form by electronic communication by JustFund emailing you the disclosure statement to your email address nominated in this application.*

Yes
Keeping your information private and confidential is really important. JustFund's Privacy Policy is available here and Confidentiality Agreement is available here.
Do you agree to JustFund's Privacy Policy and Confidentiality Agreement?*

Yes
As part of your application, we will complete a credit check using Equifax.

By submitting this application, you agree that JustFund is asking you for personal information about you so as to use Equifax’s credit reporting service to credit check you. Equifax is a credit reporting agency whose website address is www.equifax.co.nz. You understand and agree that:

1. Equifax will give JustFund information about you for that purpose

2. JustFund will give your personal information to Equifax and that Equifax will hold that information on their systems and use it to provide their reporting service.

3. When other Equifax customers use the Equifax credit reporting service, Equifax may give the information to those customers.

4. If You default in my payment obligations to JustFund, information about that default may be given to Equifax, and Equifax may give information about your default to other Equifax customers.

5. JustFund may use Equifax credit reporting services in the future for purposes related to the provision of credit to me.
I confirm that I understand and agree to the above.*

Yes
Application Type
Should be Empty:

Client Application Form

Your Law Firm's Details

Your Former Partner's Details

Your Relationship

Your Legal Matter

Funding Amount

A little more about you.

A little more about your former partner.

Your nearly there! This is the final page!