Application for Finance
Don't Dream it, Drive it!
Assisted By
*
Chantele Smith
Referred by?
Are you currently under DEBT REVIEW?
*
YES
NO
If you do not qualify for vehicle finance, would you be interested in RENT TO OWN?
*
YES
NO
Description of Vehicle You're Looking For
Personal Details
First Name
*
Middle Name
Surname
*
Identification type?
*
South African ID
ID Number
*
ID Number (Confirm)
*
Do you have a valid Driver's License?
*
Yes
No
Instalment Type
With Deposit
No Deposit
Language Preference
Gender
*
Male
Female
Ethnic Group
Asian
Black
Coloured
Indian
White
Country Nationality
*
Marital Status
*
Single
Married
Divorced
Widower
Marital Contract
ANC
COP
Date Married
-
Month
-
Day
Year
Date
Mobile Number
*
Alternative Number
Work Number
*
-
Area Code
Phone Number
Email
*
Residential Details
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owner - Bonded
Owner - Bonded
Owner - Bond Free
Tenant
Lodger
Living With Parents
Period Here (Years)
*
Employer Details
Employer Name (Company Name)
*
Occupation
*
Industry Type
Private
Government
Farming
Mining
Self Employed
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Period Employed (Years)
*
Gross Salary (Before Deductions)
*
Nett Salary (After Deductions)
*
Frequency of Salary
*
Monthly
Weekly
Fortnightly
Monthly Expenses
Please indicate monthly expenses
Bond Payment
Monthly Rent
Water & Electricity
Car Payments
Personal Loan
Credit Card
Furniture Accounts
Clothing Accounts
Policy / Insurance
Telephone Payments
Transport Costs
Food & Entertainment
Education Costs
Household Expenses
Relative Details
Family member or friend
First Name (Next of Kin)
*
Surname (Next of Kin)
*
Relationship (Next of Kin)
Phone Number (Next of Kin)
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Banking Details
Bank Account Holder Name
Bank Name
*
Account Number
*
Account Type
Savings
Cheque
Transmission
Agreement
By submitting your details you confirm that thisinformation is correct and accurate and you give Cars and Bakkies permission toshare this information with BuddyCentral (Pty) Ltd. A Holding Company,established in accordance with the law of South Africa with registrationnumber 2015/137723/07). You hereby give permission toCars and Bakkies and BuddyCentral's subsidiaries to contact you for thepurposes of offering their respective credit related services and products as aresult of your interest in completing this form / application.
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