Apply For Finance Online

Online Finance Form

Please note that this is not the full finance form. Our Sales Team will contact you for your details. We will handle the finance application with the bank of your choice.


Application :

Applicant Type :
Goods Used For :


Personal Details :

Title :
Surname :
Full Names :
Initials :
ID Number :
Sex :
Relationship Status :
Date Married : (If married)
Home Address :
Period :
Owner Tenant No: (h)
(w)
(cell)
Postal Address :
Code :
E-mail :


Spouse Details :

Names :
ID :


Relative Details :

Names :
Relationship :
Address :
Tel :

Bond Details :

Current Value-R :
O/S Bal-R :
Purchase Price :
Loan Held With :
In Name Of :
Date Of Purchase :


Employer Details :

Name :
Employee No :
Employee Address :
Yrs and Months Worked :
Salary Date :
Previous Employer :
Yrs and Months Worked :
Spouse Employer :
Yrs and Months Worked :
Tel :
Occupation :


Banking Details - Applicant :

Bank Name :
Branch Name :
Account Number :
Branch Code :
Account Type :


Language Preference :

Language :
Other :

Nominated Driver (If Applicable) :

Name :
Relationship :
ID No :
Client cont. :
ID No :


Household Income Details - Applicant (Per Month) :

Basic Salary :
Car Allowance :
Monthly Commission :
Income Other than Salary/Wages :
Salary Deductions :
Nett Take Home Pay :
Total Nett Monthly Household Income (A) :


Are You Currently Liable As :
Specify Details of Debt :
If You Have Signed Surety Or Co-Debtor Please Indicate The Full Amount Outstanding On The Accounts :


I confirm that :

A. I am not a minor.
B. I have never been declared mentally unfit by a court.
C. I am not subject to an administration order.
D. I do not have any current application pending for debt restucturing or alleviation.
E. I do not have any current debt re-arrangement in existence.
F. I have not previously applied for a debt re-arrangement.
G. I am not under sequestration.
H. I do not have applications pending for credit, nor open quotations as envisaged in Section 92 of the National Credit Act.
I. The information provided by me in this application is true and correct.

If you have answered no for point I, please give details:

Declaration by client :

I hereby grant the Credit Provider the right :

1) to increase my Credit Limit once every year to accommodate any Value Added Products needed :
2) to authorise the Credit Provider to make enquiries about my credit record with any credit agency :
3) to obtain whatever information on me they might require to process this application :

I understand that I will be liable for a monthly service fee :

I also authorise the Credit Provider to share my payment behaviour with any credit agency and the National Loans Register :


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