Online Finance Application



Personal Details


Married: ANCCOPSingleWidowed

Bond Details



Employer Details



Bank Details


CREDIT CARDSAVINGSTRANSMISSIONCURRENT

Trade Reference


Branch
Account No.
Instalments
Paid up / Current / To Be Settled

Ethnic Group


AFRICANCOLOUREDINDIANWHITE

Language Preference


AFRIKAANS (FOR AN EXPLANATORY VERSION)ENGLISH (PRIMARY)


Personal Application Form


Salary Details
Own
Spouse
Basic Salary(Excl Car Allowance)
Car Allowance
Total Salary (Basic & Car Allowance)
Monthly Commission
Net Take Home Pay
Income Other Thans Salary/Wages**

Household's Expenses Per Month:


Bond Payment / Rent
Rates, Water and Electricity
Vehicle Instalments (Excluding Those To Be Settled)
Personal Loan Repayments
Credit Card Repayments
Furniture Accounts
Clothing Accounts
Overdraft Repayments
Policy / Insurance Repayments
Telephone Repayment
Transport Costs
Food and Entertainment
Education Cost
Maintenance
Household Expenses
Other
Are You Currently Liable As:
CO-DEBTORGUARANTORSURETYNONE
Specify Details:
If You Have Signed Surety Or Co-Debtor Please Indicate The Full Amount Outstanding

Documentation


3 Month's bank statements (6 Months if self employed)




Proof of employment (Latest pay-slip x3)



(Self employed - Copy of CK docs)


  1. I am not a minor.
  2. I have never been declared mentally unfit by a court.
  3. I am not subject to An administration order.
  4. I do not have any current application pending for debt restructuring or Alleviation
  5. I do not have any current debt re-arrangement existence.
  6. I have not Previously Applied for a debt re-arrangement.
  7. I am not under sequestration.
  8. I do not have applications pending for credit, not open quotations as envisaged in section 92 of the national credit act.
    if any the above is incorrect give details :
  9. I hereby grant the Credit Provider the right to communicate with me through any eletronic/written media or verbally in order to make available to me, their product offering.

    yesNo

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