Finance Form

If you do not owe anything or do not have any details, fill in with a 0.

Sales Representative
Which Vehicle (ie 2010 2.0)
Personal Details
Title
Surname
Full Names
Cell Number
Email Address
Sex
ID Number
No. Of Dependants
Marital Status
Marital Contract
Date of Marriage (dd/mm/yyyy):
Home Address
Street 1:
Street 2:
Street 3:
Suburb :
Find Postal Code
City :
Postal Code:
How long have you stayed at this address? (Years/Months):
Postal Address :
Copy Physical Address
P.O. Box 1 :
P.O. Box 2 :
P.O. Box 3 :
P.O. Box Suburb :
Find Postal Code
P.O. Box City :
P.O. Box Postal Code :
Telephone(Home):
Telephone(Work):
Spouse Name(if Married):
Spouse ID(if Married):
Spouse Cell Number(if Married):
Details of Somebody NOT Living With You
Name:
Surname:
Cell Number:
Relationship
Address:
Employer Details
Employers Company Name:
Managers Name:
Occupation
How long have you worked there?:
Employers Address:
Employers Telephone:
What date do you get paid:
Banking Details
Who do you Bank With?
Type of Account?
Bank Branch Name?:
Bank Account Number?
Bank Branch Number?
Name of Account Holder
Income and Expenses
Total Income Before Deductions
Total Income After Deductions
Total Expenses ie Rent, Vehicles, Food, Telephone, Electricity, etc
Breakdown of Expenses
Bond Payment / Rent
Rates, Water, & Electricity
Vehicle Installments
Personal Loan Repayments
Credit Card Repayments
Furniture Accounts
Clothing Accounts
Overdraft Repayments
Insurance Repayments
Telephone Payment
Transport Costs
Food and Entertainment
Education Costs
Maintenance
Household Expenses
Other
Agreement
By checking the check box below I hereby give consent to the Credit Provider to make enquiries about my credit record with any of credit agencies and to obtain whatever information on me that they might require to process the credit application and / or application for insurance. I hereby declare that all of the above information is true and correct . I also consent to all related parties for the collection and use of this information. *
SUBMIT