HRNILS ENQUIRY FORM ONLY

ADDITIONAL INFORMATION WILL NEED TO BE PROVIDED AFTER YOU SUBMIT YOUR FORM

Am I Eligible for a NILS loan?

To be eligible you must:

have a health care card, pension card OR
earn less than $57,000 a year (after tax) if single, OR
less than $75,000 a year (after tax) for couples or people with children.
have lived in your current or previous residence for at least 3 months.

**Special circumstances may be considered**

How do I apply?

STEP 1:
Complete and submit this enquiry form.

STEP 2:
Provide additonal information to help us create your application.

PERSONAL DETAILS

Date

CLIENT 1

First Name *

Last Name *

Date of Birth *

CRN *If you don't have a Centrelink Customer Number, please type 'NA' in box

Phone *

Email

Address *

Suburb or Town *

State *

Postcode *

Enter Client 2 Details

CLIENT 2

First Name *

Last Name *

Date of Birth *

CRN

Phone

Email

Address

The following 2 questions are used for reporting purposes and will have no impact on your application. If you feel uncomfortable in any way, please select 'Prefer not to answer'.

Do you identify as Australian Indigenous? *

Please provide details

Do you identify as having a disability *

Please select

Please provide details

HOUSING

Housing type *

Please provide details

Time at current address *

If less 0-3 at your current address, please provide your previous address below

Time at previous address

If you have spent less than 3 months at both your current and previous address , please provide details below

SECONDARY CONTACT

First Name *

Last Name *

Phone *

Relationship *

How did you find out about NILS? *

Please provide details

What would you like to purchase? *

Hunter Region NILS Centrelink Confirmation eServices (CCeS) Authority

If you would like us to download your Centrelink Statement for you, please carefully read and complete the following form.

Do you authorise:

Hunter Region No Interest Loans Scheme Inc. (Hunter Region NILS) to use Centrelink Confirmation eServices to perform a Centrelink enquiry of your customer details in order to enable the business to determine if you qualify for a NILS service.
Services Australia to provide the results of that enquiry to Hunter Region NILS and Good Shepherd Australia New Zealand.

Do you understand:

Services Australia will disclose personal information to Hunter Region NILS including your name, payment type, payment status, one off payment, income, assets, deductions, shared care arrangements and Youth Allowance Independent Rate to confirm your eligibility for relevant NILS service.
this consent, once given, remains valid while you are a customer of Hunter Region NILS unless you withdraw it by contacting Hunter Region NILS or Services Australia.
You can get proof of your circumstances/details from the department and provide it to Hunter Region NILS so that your eligibility for relevant NILS service can be determined.
if you withdraw your consent or do not alternatively provide proof of your circumstances/details you may not be eligible for the NILS service provided by Hunter Region NILS.

If you have any questions, please contact us before completing the following:

CLIENT 1

Do you give Hunter Region NILS permission to use CCeS to download your Centrelink Statement? *

Name *

Date and Time *

CLIENT 2

Do you give permission for Hunter Region NILS to use CCeS to download your Centrelink Statement?

Name *

Date and Time *

CONFIRMATION OF BOARD OR PRIVATE RENT

Please complete this form if you pay board, or private rent (not to a real estate agent).

I

currently live at

I have lived at this address for

Please include your previous address in the 'Additional Notes' section below:

My current board/rental payment is:

per

Don't forget to 'tick' all expenses covered in your board or private rental payment

If you are happy for us to confirm your board or rental payments, please provide contact details for your housemate or private landlord below:

First Name

Last Name

Phone

Email

Please include any other information to help explain your current housing situation below:

Additional Notes:

NILS CLIENT RIGHTS & RESPONSIBILITIES

NILS is based on trust and the circular community credit model. Every repayment made by current clients is used to lend to others in the community.

Before you submit your application, please take some time to read the information provided below:

CLIENT RIGHTS

Be treated fairly and with respect regardless of your personal circumstances and beliefs.
Be told if you can apply for a loan and how to do so.
Know and agree to what happens to the information we keep about you and your financial situation.
Give feedback or make a complaint without it affecting whether or not you get help from us.
If available, access an interpreter, advocate, or other support person to assist with the NILS application.
Receive a loan without fees, charges or interest if your application is approved.
Be informed about the loan decision making process.
Be referred to financial counselling if you need to.
Put NILS repayments on hold or change the amount you repay if you get into difficulties repaying the loan.
Restart loan repayments if you stop.
Be able to apply additional lending once you've met the 90 days (3 months) no missed repayment criteria (up to a total of the higher limit of the combined loan purposes if you can afford it).
Be able to apply for another NILS loan (up to a total of the higher limit of the loan purpose if you can afford it) if you are eligible once you’ve successfully repaid your current loan.

CLIENT RESPONSIBILITIES

Act in a manner that respects the rights of other clients, staff and volunteers of the organisation.
Give clear information to assess the loan.
Make sure the information you give us is accurate.
Let us know if you’re happy or unhappy with our service without being rude or aggressive.
Tell us if you would like someone with you during the loan interview or to help with the loan application.
Make regular payments and pay the loan back so that someone else in the community can get a loan like you did.
Ensure all information provided is true and correct, and that no false or misleading information is given at any time.
Tell us if you have any financial difficulties now.
Tell us if you have any financial difficulties in the future. Restart payments as soon as possible.
Make regular payments when you restart, tell us if you have any financial difficulties in the future.
Meet the repayment amounts for the first loan and for any additional borrowings.
Be able to meet the repayments for the new loan.

A LIST OF THE ADDITIONAL DOCUMENTS WE NEED WILL BE AUTOMATICALLY EMAILED TO YOU WHEN YOU SUBMIT YOUR FORM

If don't have an email address or you would also like a copy of the checklist sent to your mobile, please tick the box below:

Yes, I would like a copy sent to my mobile number

Please send your supporting documents, and any questions to you may have to our email address info@hrnils.org.au.

Remember we are here to help.