Application for Vehicle Finance
Please complete the Application form.
I hereby confirm the Following:
*
I am not under Debt Review
I earn more than R8000.00
I have a valid drivers license
My credit score is 590 upwards
Full Names & Surname
*
First Name
Last Name
ID Number
*
Confirm ID Number
*
Gender
Please Select
Male
Female
Mobile Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Work Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Marital Status
*
Please Select
Single
Married
Divorced
Widow/er
Marital Type
Please Select
ANC
COP
TRIBAL
Marriage date
What vehicle are you looking for
Email Address
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you Bonded, Bond Free or Tenant? Please choose
Please Select
Bonded
Tenant
Period at current Home Address
Company Name
*
Occupation
*
Employment type
Please Select
Permanently Employed
Self Employed
Pensioner
Is your company Registered?
Yes
No
Employer Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Period at Employer
*
Salary Payment Date
*
Salary frequency
Please Select
Monthly
Weekly
Fourthnight
Gross Income
*
Nett Income
*
Rent/ Bond Payment
Vehicle Installment (If not settling)
Personal Loan
Furniture Account
Clothing Account
Policy/ Insurance
Telephone
Transport Cost
Food & Entertainment
Houshold
Next of Kin - PLEASE NOTE: NOT RESIDING AT THE SAME ADDRESS AS APPLICANT
*
First Name
Last Name
Next of Kind Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relationship
*
Next of Kin Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Bank Name
*
Bank Account Number
*
Account Type
Please Select
Savings
Cheque
Current
Do you have a trade in?
Yes
No
Do you have a Deposit?
Yes
No
I hereby confirm that the above information is true and correct.
Yes
We require your consent to utilise this information for the application for vehicle finance and products that will be made available to you. I hereby consent to the information to be made available to credit providers. I hereby consent you to collect data from the credit providers/ bureaus to verify my information given by me on the application form.
Yes
Submit
Should be Empty: