Application for Finance

Income and expenses
Applicant income details
Basic salary
Car allowance
Commission
Overtime
Other
Source of other income
Total salary
Net salary
Total monthly income
Spouse/Partner income details
Basic salary
Car allowance
Commission
Overtime
Other
Source of other income
Total salary
Net salary
Total monthly income
Expense details
Bond payment
Vehicle instalments (excl those to be settled)
Credit card payments
Clothing accounts
Policy/Insurance repayments
Transport costs
Education costs
Property rent
Total monthly applicant/household expenses
Rates, water and electricity
Personal loan repayments
Furniture accounts
Overdraft payments
Telephone payments
Education costs
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 full amount outstanding
Please tick your preferred method of communication

All Email Post Telephone SMS

Declaration by applicant
1. 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 applications pending for debt restructuring or alleviation.

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, 2005.

i. If any of the above is incorrect, state which and give 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 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 a vehicle finance.

Yes No
4. Please Tick

I hereby declare that all of the above information is true and correct.
Applicant signature:
Date

Month Day Year
Date

Expense details