Vehicle Application Form
Zelco Motors
Make and model of the vehicle that you are interested in
Ex. 2019 Mitsubishi Triton
I hereby confirm the following
I have a valid drivers license
I am not under debt review
I hereby authorise Zelco Motors to use the information provided to apply for finance.
Full Name & Surname as per ID
*
Full names as per ID
Surname as per ID
ID Number
*
13 digits
Phone Number
*
-
Area Code
Phone Number
Marital Status
*
Single
Married Out of community of property
Married In community of property
Divorced
Widow / Widower
Date Married
*
-
Month
-
Day
Year
Date (if not use today's date )
Email Address
*
example@example.com
Address as per proof of residence
*
Home Address
City
Are you a Home Owner?
If homeowner , are property bonded? (Balance)
Period at current home address: Year and months
Work Related information
*
Employer name:
Occupation
Work Address
Work Telephone Number
Period employed: yymm
Employment Type
Individual
Self Employed
Pensioner
Bank Details
*
Bank Name
Account Number
Gross Salary
Nett Salary
Salary Paid into bank date:
Bank Account Type
Savings
Current
Cheque
Do you have a vehicle to trade in?
Yes
No
Is the vehicle under finance?
Yes
No
Do you want deposit?
Yes
No
Other
Value Added Products
Cover Plus
Credit Life
Deposit Protect
Name of you short term insurance broker
Do you need us to get you a quote for short term insurance on your new vehicle?
Yes
No
Relative details NOT SPOUSE OR PERSON LIVING AT THE SAME ADDRESS
*
Name & Surname
Address
Relation
Phone number
Specify other income
Please Select
Consulting
Pension
Rent
Sales
Transport
Other
Applicant Expenses
Applicant Expenses
*
Amount
Bond payment/rent
Rates water & electricity
Vehicle installments
Personal loan repayments
Credit Card repayments
Furniture accounts
Clothing accounts
Overdraft repayment
Policy / Insurance payments
Telephone payments
Transport costs
Food and Entertainment
Education costs
Maintenance
Household expenses
other
Signature
Print Form
Save
Submit
Should be Empty: