Vehicle Pre-approval Form
Title
*
Please Select
Mr
Mrs
Miss
Ms
Customer Details:
Full Name
*
First Name
Surname
Date Of Birth
*
-
Month
-
Day
Year
Date
ID Number
*
Phone Number
*
Please enter a valid phone number.
Bank Name
*
Please Select
Capitec
ABSA
Standard Bank
FNB
Nedbank
Tymebank
Other
Account Number
*
E-mail
*
example@example.com
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What Type of Car do you need
Preferred Installment
Employment Details:
Employment Type
*
Please Select
Employed
Self Employed
Retired
Other
Company Name
*
Work Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Industry
*
What is the company doing
Occupation
*
What work do you do
Date of Engagement
*
-
Month
-
Day
Year
Date you started
Monthly Salary
*
Gross
Nett
Pay Date
*
If Other, Please Specify
Work Phone Number
*
Name, Surname and Contact number of Relative/Friend
*
Name and Surname
Contact Number
1
Who referred you
*
Your Referal will be paid R2500 upon delivery of your vehicle
Are you currently doing application with another dealership?
*
Please Select
YES
NO
By signing here I agree in line with POPI Act that I give permission to use my information given for this application. I further agree that upon approval i shall not sign contract with another dealership.
*
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