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Your Name (required)

Your Surname (required)

Your Email (required)

* ID Number (required)

* Gender (required)

* Address (required)

* Tel Work (required)

* Tel Home (required)

* Tel Cell (required)

* Marital Status (required)

* Number of Dependants (required)

* Drivers License (required)

* Gross Income (required)

* Net Income (required)

* Where do you Bank (required)

* Bank Account Number (required)

* Type of Account (required)

* List Living Expenses and Amounts

* List Living Expenses and Amounts

* List Employment Info(Employer, Contact Details etc)

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Spouses/Next of Kin Details

Name (required)

Surname (required)

Spouses Email (required)

* Spouses ID Number (required)

* Gender (required)

* Address (required)

* Tel Work (required)

* Tel Home (required)

* Tel Cell (required)

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 The vehicle is a rebuilt or stolen/recovered (Code 3)?

 The value of the vehicle is more than R30 000?

 Do you (the applicant) have a valid SA drivers license?

 Do you (the applicant) have a clear credit record?

 Are you (the applicant) a South African citizen?

 Do you (the applicant) earn R4 500 or more per month?

Load a copy of ID Book

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By submitting this you confirm that:

A. You are not a minor.

B. You have never been declared mentally unfit by a court.

C. You are not subject to an administration order.

D.You do not have any current application pending for debt restructuring or alleviation.

E. You do not have any current debt re-arrangement in existence.

F. You have not previously applied for a debt re-arrangement.

G. You are not under sequestration.

H. You do not have applications pending for credit, nor open quotations as envisaged in section 92 of the National Credit Act.

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DECLARATION BY CLIENT:

1. I hereby grant the Credit Provider the right to communicate with me through any electronic / written media or verbally in order to make available to me, their product offering and to utilize my information for supporting products as Communicated by one of the Credit Provider\'s Partners.

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

3.I authorize the Credit Provider to make inquiries about my credit record with any credit agency and to obtain whatever information on me they might require to process this application.

4.I also authorize the Credit Provider to share my payment behavior with any credit agency.

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