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| Finance Application Form |
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Vehicle Description
| Make: | M&M Code: |
| Model: | |
| Year: | |
| Price: | |
| Deposit: |
Purpose for which car is required
| Period of contract: |
Personal information
| Your title: | |
| Your surname: | |
| Your names: | |
| Your ID |
Residential information
| Present residential address: | Previous residential address: | Postal address: |
| Postal code: | Postal code: | Postal Code: |
| How long at present address ? | years months |
| Dou you have your own property ? | Estimated Value Outstanding Bond |
| Outstanding Bond ? | Which Bank is Bondholder |
| How long at previous address ? | years months |
| Home Area code and Tel no: | |
| Cell phone number: | |
| E-Mail Address: |
Occupation / Employment information
| Company name: | |
| Company telephone no.: | |
| Employers Occupation: | |
| Type of Industry: | |
| Employers Name: |
| Employers Address: | Previous Employers Address: |
| How long with your present employer ? | years months |
| How long with your previous employer ? | years months |
| What is your gross monthly income ? | R per month |
| What is the value of your car allowance ? | R per month |
| Addisional Income: | R per month |
| Total Income: | R per month |
Marital Status
| Status: | Single Married Widowed |
| Date Married: |
| ANC COP OTHER |
Spouses Details
| Name: | |
| Salary per Month: | |
| Id. Number: | |
| Date of Birth: | |
| Employer Name: | |
| Employer Address: | |
| Occupation: | |
| Period of Employment at current Employer: |
Relatives Details
| Name of next of kin not living with you: | |
| Address of next of kin not living with you: | |
| Relationship: | |
| Area Code & Tel No: |
Banking Details
| Which Bank do you bank with: | |
| Branch: | |
| Type of Account: | Savings Cheque Transmission |
| Type of Credit Card: | None Visa Master card Other |
Do you have existing or previous accounts with vehicle finance ?
| Name of Company you financed with: | |
| What type of account do you have: | |
| Do you have your own insurance: |
If deposit is a trade in, Please specify Make, Model and Year
| Make: | Model: |
| Year: | km Settlement Amount |
| Any extras eg. (New tyres etc.): |
