Application of Finance Individual Application of Finance Step 1 of 2 50% GOODS DESCRIPTIONModel Make PERSONAL DETAILSClient Type SA citizen residing in SA Foreign national residing in SA Asylum seeker Refugee SA citizen residing abroad Title Surname Identity Number(Required) Full Names Initials Email Place of Birth Nationality Gender Male Female Marital Status OCOP COP Single Widowed Divorced Customary Law/Tribal Married under foreign law Date Married Home Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Period Country of residence Residential address/Geographic location Tel (H)Tel (W)CellFaxPostal Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email Spouse Name Spouse Identity Number Next of Kin Relationship Address TelAre you a registered VAT vendor? Yes No VAT reg no Ethnic group African Coloured Indian White Language Preference English (Primary) Afrikaans Other If Other BOND DETAILSBondholder Registered Own Name Spouse Renting Amount EMPLOYER DETAILSEmployer Occupation Industrial type Employer Address No of years Salary Date Previous Employer No of years Spouse employer No of years TelOccupation Applicant Signature(Required)Date BANKING DETAILSBank Name Branch Name Branch Code Name of accountholder Account no Type of account Savings Current Source of income Salary earner Self-employed Commision Director Pensioner Maintenance Court Order Member of close corporation TRADE REFERENCEBranch Account no Installments Paid up / Current / To be settled Branch Account no Installments Paid up / Current / To be settled INCOME AND EXPENSESBasic salary Spouse basic salary Car allowance Spouse car allowance Commission Spouse Commission Overtime Spouse Overtime Other Spouse Other Source of other income Spouse other household income Total salary Spouse total salary Net salary Spouse net salary Total Salary EXPENSE DETAILSBond payment Rates, water and electricity Vehicle installments (excl those to be settled) Personal loan repayments Credit card payments Furniture accounts Clothing accounts Overdraft payments Policy/insurance repayments Telephone payments Transport costs Food and entertainment Education costs Education costs Property rent Other Total monthly applicant / household expenses Total monthly applicant / household surplus / disposal income Are you currently liable as Surety Guarantor Co-debtor Specify details If you have signed surety or are a co-debtor, please indicate the full amount outstanding Please tick your preferred method of communication All Email Post Telephone SMS I hereby provide my/our express consent to the credit provider to request bank statements of the bank account(s) listed below, for the sole purpose of applying for vehicle finance Yes No Declaration by applicant1 . I confirm that: a. I am not a minor. b. I have never been declared mentally unfit by a South African court. c. I am not subject to an administration order. d. I do not have any current application pending for debt restructuring or alleviations. e. I do not have any current debt rearrangement in place. f. I have not previously applied for debt rearrangement. g. I am not under sequestration. h. I do not have applications pending for credit, nor open quotations as envisaged in section 92 of the National Credit Act, 2005i. If any of the above is incorrect, state which and provide details. 2. I hereby give consent to the credit provider to make enquiries about my credit record with any credit agency and to obtain whatever information on me they might require to process the credit application and to share my payment behaviour with any credit agency. Yes No 3. I hereby declare that the above is true and correct.Signed at On Day / Month / YearSupporting Documents Drop files here or Select files Accepted file types: pdf, docx, jpg, png, jpeg, Max. file size: 50 MB. ID Document, bank statement, proof of residence, Support formats(pdf, docx, jpg, png, jpeg)Applicant(Required)Applicant Signature
