Individual Application for Finance


Vehicle Details


Personal Details




Employer Details


Home Ownership (If Applicable)


Bank Details


Applicant's Income Details


Applicant's Expenses per Month

I confirm that:

  • I am not a minor.
  • I have never been declared mentally unfit by a court
  • I am not subject to an Administration Order
  • I do not have any current application pending for debt restructuring or alleviation.
  • I do not have any current debt re-arrangement in existence.
  • I have not previously applied for a debt re-arrangement.
  • I am not under sequestration.
  • I do not have applications pending for credit, nor open quotations as envisaged in section 92 of the National Credit Act.
I understand that I will be liable for a monthly service fee.
I hereby consent to this Credit Provider making enquiries regarding my credit history with any credit bureau.
I consent to this Credit Provider reporting the conclusion of any credit agreement with me to the National Loans Register in compliance with this Credit Provider ’s obligation under the National Credit Act.
I hereby declare that the information provided by me is true and correct.

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