Hardships Request Form | Rapid Loans Pty Ltd

Hardship Request Form

If you are unable to meet your current loan obligations due to illness, unemployment or other reasonable cause, please complete the following form. If you are unable to complete this form online, please call our team on 1300 660 531 and they will complete this over the phone with you.

Once submitted, our dedicated team will be in touch as soon as possible.

Account ID (if known)

Customer Details

Name

First

Last

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Reason for Hardship

Primary Reason for Hardship Request

Secondary Reason for Hardship Request

Income & Expenses

(Monthly) (Monthly) Layout

Income (Monthly)

Expenses (Monthly)

Enter your regular living costs (rent, utilities, groceries, transport, insurance, etc.)

Liabilities (Monthly)

Enter repayments/obligations to other lenders (mortgage, credit cards, BNPL, other loans, child support). Do not include this loan repayment.

Surplus (Monthly)

Requested Assistance

Type of Assistance Required

Reduced Repayments
Moratorium
Interest & Fee Hold

Requested Duration of Assistance

e.g. 3 months

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