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Finance Application
Online Finance Application
Complete our pre-qualification assessment to see if you qualify for finance. Upon submitting the application, our dealer representative will contact you within 24 hours with a review of your assessment or to request additional information if needed.
Note: Please complete all fields to ensure prompt processing.
Online Finance Application
Title *
Name *
Surname *
ID Number *
Mobile *
Email *
1a. Home address
1b. Specify - Rent or Own ?
1c. Number of years residing at current home address
2a. Married ?
Yes
No
2b. Date of marriage
2c. Marriage in community of property ?
Yes
No
3a. Bank name
3b. Branch
3c. Branch code
3d. Name of account holder
3e. Account number
3f. Account type
4a. Occupation
4b. Type of Industry
4c. Employer name
4d. Employer address
4e. Telephone Work
4f. Number of years at current company ?
5a. Gross monthly income
5b. Nett monthly income
5c. On which date of the month is your salary pay day ?
5d. Bond monthly payment
5e. Food and Entertainment monthly payment
5f. Transport monthly payment
5g. Clothing and Furniture Account monthly payment
5h. Cellphone Contract monthly payment
6a. Vehicle trade in available ?
Yes
No
6b. Trade in brand & model
6c. Trade in registered year
6d. Trade in paid off ?
Yes
No
6e. Settlement amount
6f. Bank/finance house
7a. Which vehicle are you interested in financing ?
7b. Specify New or Used ?
8a. Name and Surname of next of kin/friend/relative (not living with you)
8b. Number of next of kin/friend/relative (not living with you)
8c. Home Address of next of kin/friend/relative (not living with you)
8d. Relationship to Yours of next of kin/friend/relative (not living with you)
9a. Are you currently under debt review? *
Yes
No
9b. Do you have a valid driver's license? *
Yes
No
10a. I hereby declare that all of the above information is true and correct *
Yes
No
10b. I give consent to the credit provider to make enquiries about my credit record *
Yes
No
I hereby consent to receive marketing communication
Yes
I hereby consent for you to process my personal information:
*
Yes
Preferred contact method:
Phone (call)
Phone (SMS)
Email