Online Finance Application

Personal Details

Bond Details

Employer Details

Bank Details

Trade Reference

Ethnic Group

Language Preference

Personal Application Form

Household's Expenses Per Month:

1. I am not a minor.
2. I have never been declared mentally unfit by a court.
3. I am not subject to An administration order.
4. I do not have any current application pending for debt restructuring or Alleviation
5. I do not have any current debt re-arrangement existence.
6. I have not Previously Applied for a debt re-arrangement.
7. I am not under sequestration.
8. I do not have applications pending for credit, not open quotations as envisaged in section 92 of the national credit act.
   if any the above is incorrect give details :
   
9. I hereby grant the Credit Provider the right to communicate with me through any eletronic/written media or verbally in order to make available to me, their product offering.
   
   yesNo

I hereby grant the Credit Provider the right to increase my Credit Limit once every year to accommodate any Value Added Product needed and request by me.

I hereby declare that all the above information is true and correct.

Consent to electronically obtain statements from financial institions

This information is private and confidential and will not be distributed to third parties