State Mercantile | Hardship Application

State Mercantile understands that at times our customers experience financial hardship. We recognise the need to deal with people under severe financial difficulties with empathy and understanding. Our Hardship Policy has been developed to assist you to manage your account in a mutually beneficial way.

So that we can assess your application in a timely manner please fill out all relevant sections of the following form and attach all documentary evidence in support of your application.

Please view our hardship policy here.

Customer Details

Full name (required): Your name is required

Account reference (required): Please enter a valid reference number

Date of birth (required):

required

Email (required): Please enter valid email address

Contact number (required):

Alternative contact number:

Street Address (required):

Suburb (required):

State (required):

Postcode (required):

What was/is the cause of your financial hardship? (required): When and how did your financial difficulties begin as a result of the above? (required): What is the expected period of your financial difficulties? (required): If you expect your financial difficulties to be long term, why?
If you expect your financial difficulties to be short term, what changes in your circumstances do you expect to occur, and when? (required): If you expect your financial difficulties to be short term, please provide any paperwork you have to confirm the likelihood of these changes

Only .pdf, .doc, .docx, .png and .jpg files.

How do you propose that your loan should be varied on account of your financial hardship? Please indicate what amount, if any, you are able to contribute to your loan repayments at the moment? (required): [note] Is there any other information that you consider relevant to your request for a financial hardship variation?:

Security

What is the estimated value of the property (e.g. car or house) that is the security for the loan?

Type of security 1: Type of security 2: Type of security 3: What is your current monthly household income after tax? Salary:

Business Income:

Rental Income:

Centrelink Benefits:

Child Support:

Other (indicate source):

Other (amount):

Security cost 1:

Security cost 2:

Security cost 3:

What are the values of your other assets? Properties:

Vehicles:

Superannuation:

Bank Balance:

Other (indicate source):

Other (amount):

Living Expenses

Rent:

Council Rates:

Water Bill:

Gas or Electricity bill:

Telephone bill:

Insurance:

Other (indicate type):

Food:

Clothing:

Medical Expenses:

School Fees:

Car Costs:

Other Travel Expenses:

Other (amount):

Current Debts

What are your current debts and minimum repayments?
Please include the name/s of the lender.

Your Home loans:

Balance:

Required Monthly Payment:

Monthly Payment Made:

Arrears Amount:

Personal loans/Credit Cards:

Balance:

Required Monthly Payment:

Monthly Payment Made:

Arrears Amount:

Other Debts:

Balance:

Required Monthly Payment:

Monthly Payment Made:

Arrears Amount:

Supporting Documentation

Please provide all relevant supporting documents: [help?]

Only .pdf, .doc, .docx, .png and .jpg files.

Please leave blank: