Finance Application Form
Finance Application Form
Term : 48 60 72
FINANCE Wesbank ABSA MFC Standard Balloon : _____ %
Choice of bank Deposit : R ____________
Rate : Linked Fixed
PERSONAL ID PASSPORT
DETAILS NUMBER: NUMBER:
Title: Surname: Full names:
Yrs Mths
Postal address: Postal code: Cell nr
e-mail address:
Relation to client
GRADUATE Yes No
EMPLOYMENT Company: Occupation:
DETAILS:
Company Work nr: Period employed
address:
Yrs Mths
GROSS INCOME
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 restructuring 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.
* If any of the above is incorrect, state which and give details:
I hereby declare that all of the above information is true and correct.
06/09/2023
Signed _____________________________________ Date ______________