Finance Application Form
Would you like to apply for finance? Please feel free to complete the finance application form below, which we will submit to the banks on your behalf. All information you supply will be treated as private and confidential.
1. PERSONAL DETAILS (Application For Installment Finance)
1.1 Applicant details
Title :
Mr
Ms
Mrs
Dr
Prof
First Name :
Surname :
Second Name / s :
ID Number :
Language Preference :
English
Afrikaans
Zulu
Sotho
Ethnic Group :
African
Coloured
Indian
White
Email Addr :
Driver's Licence Nr :
PO Box Addr :
Home Addr :
Postal Code :
No. of yrs at Home Addr :
Previous Home Addr :
No. of yrs at Previous Addr :
Gender :
Male
Female
Dependants :
Marital Status :
Single
Married COP
Married ANC
Widow
Divorced ANC
Date Married :
Spouse Name :
Spouse ID Number :
Occupation :
Total Salary :
Car Allowance Included In Total Salary :
Total Net Income :
Other Income
(Not Salary/Wages) :
Source Of Other Income :
Spouse Occupation :
Spouse Total Salary :
Salary Date:
Total Monthly Household Income :
Employer :
No. of yrs at Current Employer :
Previous Employer :
No. of yrs at Previous Employer :
Spouse Employer :
1.2 Telephone Numbers
Home :
Work :
Cell :
2. OTHER DETAILS (Application For Installment Finance)
2.1 Bank Details
Bank Name :
Branch :
Branch Code :
Type of Account :
Cheque
Savings
Transmission
Credit Card
Name Of Account Holder :
Account Number :
2.2 Bond Details
Bond Holder (institution) :
Purchase Price :
Property Value :
Amount Outstanding :
Date Purchased :
Instalment :
Registered :
Own Name
Spouse
2.2.1 Non Registered Bond
Renting :
No
Yes
Monthly Rent :
2.3 Next of Kin Details
Name :
Surname :
Contact Number :
Address :
Relationship :
3. VEHICLE DETAILS (Application For Installment Finance)
3.1 Dealer Detials
Dealer / Supplier :
Telephone No. :
Sales Person :
Fax :
3.2 Vehicle Description
Make :
Model :
Purchase Price :
Year of Manufacture :
Deposit / First Payment :
Expected Instalment :
4. HOUSEHOLD'S EXPENSES (Application For Installment Finance)
4.1 Houseold's expenses per month
Rates,Water and Electricity :
Vehicle Instalment
Excluding Those To Be Settled :
Personal Loan Repayments :
Credit Card Repayments :
Furniture Accounts :
Clothing Accounts :
Overdraft Repayments :
Policy/Insurance Repayments :
Telephone Payment :
Transport Costs :
Food And Entertainment :
Education Costs :
Maintenance :
Other :
Total Household Expenses :
Total Surplus :