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VEHICLE FINANCE APPLICATION

Vehicle Details

Finance Details

CUSTOMER DETAILS

Title

First Name

Middle Name

Surname

ID Number

Marital Status

Date Married

COP/ANC

Residential Address

Suburb / Area

City / Town

Renting

YES NO

Bonded

YES NO

Period at Home

Email Address

Home Number

Work Number

Cell Number

EMPLOYMENT DETAILS

Company Name

Company Address

Period Employed

Employment Title

RELATIVES DETAILS

Name and Surname

Contact Number

Relation

Residential Address

Surburb / Area

City / Town

BANKING DETAILS

Bank Name

Account Number

Account Type

INCOME AND EXPENSES

GROSS SALARY

TRAVEL ALLOWANCE

PETROL ALLOWANCE

OVERTIME

COMMISSION

NET SALARY

BOND / RENT

VEHICLE INSTALLMENT

TELEPHONE

POLICY INSURANCE

CLOTHING

FURNITURE

CREDIT CARD

PERSONAL LOAN

HOUSEHOLD EXPENSE

TRANSPORT AND PETROL

OTHER EXPENSES

Total:

I hereby grant the Credit Provider the right to communicate through any electronic/written media or verbally in order to make available to me, their product offerng and to utilise my information for supporting products as communicated by one of the Credit Provider Partners

YES NO

I authorise the Credit Provide to make enquiries about my credit record with any credit agency and to obtain whatever information on me they might require to process this application.

YES NO

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