Finance

Application for Finance

First Name *

Middle Name

Surname *

Home Address *

Postal Address *

Marital Date *

Married

Marital Status

Gender *

Race *

Graduate

Cell Number *

Home Number *

Email *

Period at Address *

Employment Details

Name of Employer ( as per payslip ) *

Business Telephone Number *

Occupation *

Government Employee

Fax Number

Period at Employer *

Home Finance

Employer Address *

Bond Holder Name

Title Holder Name

Payment per Month

Bank Name

Bank

Account type

Acc no:

Branch

Salary Paid in to this account ? *

Next of kin details THAT DOES NOT LIVE WITH YOU

First Name and Surname *

Relative\'s Telephone Number *

Relative\'s Address *

Vehicle Details

Year *

Make *

Kilometers *

Model *

M&M Code

Cash Price ( incl.)

License and Reg

Service and Delivery

Paint protection

Other Extras

Deposit *

Warranty

Trade in M&M

Finance House

Value

Applicants Income details

Gross remuneration as per payslip *

Monthly commission

Car allowance

Nett as per payslip *

Salary Date: *

Other Income

Total Income

Spouse

Name

ID Number

Cell Number

Work no

Spouses Income

Joint Expenses

Bond

Rent

Water & Lights

Vehicle Installment

Personal Loan

Credit Card

Furniture Account

Clothing Account

Policies

Cell Account

Telephone Account

Transport Costs

Groceries

School Fees

Maintenance

DSTV / Domestic

Medical Aid

other

I CONFIRM THAT

I am not a minor

I am not subject to an administration order *

I have never been declared mentailly unfit by a court *

I do not have any current application pending for debt restructuring *

I have not previously applied for a debt re-arrangement *

I am not under sequestration *

I do not have applications pending for credit, nor open quotations *

I do not own a joint bond account with any party *

– I understand that I am liable for a monthly service fee.

– I hereby consent to this Credit Provider making enquiries regarding my credit history with the credit bureaux.

– I consent to this Credit Provider reporting the conclusion of any credit agreement with me to the National Loans Register in compliance with this Credit Provider’s obligation under the National Credit Act.

– I HEREBY GIVE IDX CONSENT ALLOWING THE BANKS TO ACCESS MY BANK ACCOUNTS

– I hereby declare that the information provided by me is true and correct.

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