Declaration Form

    Financial Information

    Financial Advice Provider:

    NZ Mobile Mortgages


    8 Stanway Place, Ellerslie, Auckland 1051

    Financial Adviser:

    Gaurav Chutani


    means a lender (including their associated parties)


    means an insurance product provider (including their associated parties)

    Please complete and review this Declaration Form carefully. By signing this Declaration Form you are acknowledging that you understand and agree to each of the statements set out in Sections A - I below.
    Section A: Authority to act

    Section B: Commission Arrangements

    Section C: Relationship of Financial Advice Provider

    Section D: Privacy
    D.1 Privacy Authorization

    D.2 Privacy Summary

    Section E: Legal and Valuation Costs

    I am/we are to meet legal and valuation costs in relation to obtaining a home loan.

    Section F: GST Matters

    Section G: Specialist Insurance Provider

    Section H: Loan Repayment

    Section I: Loan Application Form