Application

Financial hardship assistance request

Use this form to open a hardship review. The PDF remains available if you prefer to prepare the request offline.

Online hardship request

This form is for account holders experiencing genuine financial difficulty. Do not include card details.

Full name *

Axess reference number *

Email *

Phone *

Primary reason for hardship *

Approximate monthly income

Approximate monthly essential expenses

What has changed? *

Requested arrangement *

I declare the information supplied is true and complete and consent to Axess contacting me about this hardship request. *

Before submitting

This form starts the request; it does not upload documents or guarantee hardship assistance.

Keep bank statements, income evidence or medical documents available. If they are needed, our team will tell you how to provide them securely after your request is received.

PDF backup: Download the hardship application form if you prefer to complete the application offline.

Important declaration

Information supplied must be true and complete. False or incomplete information may invalidate an application or delay assessment.

Axess Group Pty Ltd and related entities reserve their rights in relation to the account that is the subject of any application. Any offer made by you is not accepted by Axess until acceptance is confirmed in writing by our office.