Finance Application

APPLICATION FOR INSTALMENT FINANCE

Fill all form field to go to next step

Personal
Residential
Next of Kin
Employment
Finance
Income
Expenses
Finish

Personal Details:

Step 1 - 8

Title Full Names * Surname *

Gender Ethnicity Nationality

ID Number *

Contact Details:

Preferred Contact Method Contact Number *

Alternative Contact Number Email *

Household:

Preferred Language

Marital Status

Dependants

Residential/Property:

Step 2 - 8

Home Address Period at Current Address (years)

Previous Address Period at Previous Address (years)

Postal Address

Are you: The Owner? A Tenant? A Lodger? Bond Holder

Post Code

Purchase Price

Amount Outstanding

Property Value

Monthly Instalment

Purchase Date

Next Of Kin:

Step 3 - 8

Next of Kin Full Name Next of Kin Relationship Next of Kin Full Contact Number

Next of Kin Address

Employment:

Step 4 - 8

Current Employer Occupation Period of Employment (years) Employer Phone Number

Employer Address

Next Payment Date Payment Frequency Employment Type

Previous Employer Period od Previous Employment (years)

Banking Details:

Step 5 - 8

Bank Name

Branch Name

Branch Code

Name of Account Holder

Account Number

Account Type

Payment Frequency

Employment Type

Finance Details:

Agreement

Rate Indicator

Pay in Advance

Repayment Period

Finance Initiation Fees

Deposit

Interest Rate %

Residual/Balloon Value %

Income:

Step 6 - 8

Source of Income

Gross Salary

Monthly Commission (Included in Gross)

Vehicle Allowance (Included in Gross)

Net Salary (Take Home Pay)

Other Income

Expenses:

Step 7 - 8

Bond Repayment/Rent

Transportation

Vehicle Instalments

Education

Credit Cards

Household Expenses

Clothing Accounts

Utilities, Rates & Taxes

Policies & Insurance

Loans

Furniture Accounts

Banking Costs

Telephone & Internet

Food & Entertainment

Medical

Maintenance

Other

Total Monthly Expenses

Disposable Income

Liability & Payment History:

Do you Stand Surety? Are you a Guarantor Are you a Co-Debtor

Liability Details

Are you currently under Debt Review? Are you currently under Administration order or Curator Bonus?

Have you ever had a Judgment against you to your knowledge? Are you currently under Sequestration Order?

Consent:

Do you consent to your information being shared in order to receive marketing regarding insurance and related products?

I hereby consent to the Credit Provider accessing my credit profile from the credit bureaus for the purposes of a credit assessment and in the event that my loan application is successful, for on-going account maintenance purposes, setting limits, development of credit tools/products/models and insurance purposes.

Monday:	8am–4:30pm
Tuesday:	8am–4:30pm
Wednesday:	8am–4:30pm
Thursday:	8am–4:30pm
Friday:	8am–4:30pm
Sat/Sun:	Closed