Complete Layby Application

Shipping Address
Please enter your complete shipping address
Address Line 1*
Address Line 2
Suburb
City*
Post Code*
Direct Debit Setup
Set up a secured direct debit from your bank account. Payments powered by Go Cardless
When would you like to start the direct debit?*
DD slash MM slash YYYY
Bank Code*
Branch Code*
Account Number*
Suffix*
Consent*
I provide Premium Deals Limited direct debit authorisation as per the terms set out below
By signing and/or providing us with a valid instruction in respect to your Direct Debit Instruction, you have understood and agreed to the terms and conditions governing the debit arrangements between you and Premium Deals Limited as set out in this Instruction. You agree to execute this document by electronic signature and you are aware that by electronically signing this document you are executing a legally binding document.
Identification
We need an ID to approve your application
ID Type*
- Drivers Licence
- NZ Passport
- 18+ Card
Drivers Licence number*
Version*
Passport Number*
18+ Card Number*
Expiry date*
DD slash MM slash YYYY
Upload the photo of your ID
Drop files here or

Max. file size: 64 MB.
The application can only be approved upon receiving the copy of your photo ID. Alternatively, you can email your ID at id@premiumdeals.co.nz
Date of birth*
DD slash MM slash YYYY

You must be over 18 to apply
References
Please provide us with names and contact details of 2 references who do not live at the same address as you.
Reference 1 Name
First Last
Reference 1 Phone
Reference 2 Name
First Last
Reference 2 Phone
Consent*
I agree to the website terms and conditions

Save and Continue Later

Complete Layby Application

Shipping Address

Direct Debit Setup

Identification

References