Personal Details
Residential Address
Account Information
Affordability
Expenses
Employment Information
Documentation
1/7
1. Title —Please choose an option—MrMrsMissDrOther
2. First Names
3. Surname
4. ID number
5. Mobile number
6. What is your home language —Please choose an option—EnglishAfrikaansSouth NdebeleSepediSouthern SotoSwatiTswanaTsongaVendaXhosaZulu
7. What is your marital status? —Please choose an option—SingleMarried ANCMarried COP or Customary LawDivorcedWidowed
8.What is your race? —Please choose an option—BlackWhiteColouredIndianOther
9. If you are married in community of property or by customary law, it is a legal requirement in terms of the Matrimonial Property Act, to obtain consent from your spouse to enter into any credit agreement. If so, please confirm you have received this consent. YesNo
0%
10.Street/Building name and number
11. Address line 2 (optional)
12. Suburb
13. City
14. Postal Code
15. Province We only assist application from these two provinces in South Africa —Please choose an option—Western CapeNorthern Cape
16%
16. Email
17. Confirm Email address
18. Amount you wish to borrow Take note: We do not grant loans for longer than three months.
(In terms of the National Credit Act of South Africa do you have to qualify for loan before it can be granted)
33%
Why do we need to know this information? As a registered credit provider in South Africa it is our responsibility to ensure that you are able to afford the credit you are applying for.
Therefore these questions will allow us to pre-score you to ensure you qualify for finance.
All information submitted will be treated in the strictest confidence and will not be shared with any 3rd parties or other financial institutions.
19. Monthly income before deductions (Bruto)
20. Monthly "Take home" income - after deductions (Netto)
21. Other income
50%
Please specify all your household expenses excluding credit commitments like a bond, vehicle finance, retail cards, personal loans or credit cards
22. Expense - Accommodation
23. Expense - Medical
24. Expense - Water & Electricity
25. Expense - Transport
26. Expense - Food
27. Expense - Education
28. Expense - (Maintenance)
66%
29. Employment Status —Please choose an option—Permanent / Full-timeParttime / CasualContract WorkerSelf EmployedHousewifeRetiredStudentMedically BoardedDisabilityUnemployed
30. Employment Category —Please choose an option—AccountantsAdvertising InsertsAirlinesAgricultureAlcohol & TobaccoAmusement and recreation servicesArmsArts & AntiquesAuction HousesAutomotive repair servicesCarChemicals and allied productsConstruction materialsConvenience stores (excl Franchises)Currency Exchange housesDep Brokers registered in non-rec count.Door-to-door salesEquipment for renewable energyFairground workersFinancial IndustryGaming (including internet)Gasoline and service stationsGeneral contractorsHealthcare (private sector)Import / ExportLaundromatsMobile phone operatorsMoney transmittersOil & GasOther Financial Institutions & InsuranceRetailorsOther WholesalersPersonal ServicesPolitician OrganizationsPrecious stone & metalsPrivately Owned ATMSProfessional Sport ClubsReal Estate AgentsRestaurantsShipping
31. Employment Type —Please choose an option—College / LecturerCraft SellerCreativeDriverExecutiveFarmerForces - Non-CommissionedForces - OfficerHawkerHousewifeLabourerLicensed ProfessionalManagerMinerNon-Licensed ProfessionalOffice Staff / ClerkPensionerProductionSalesSelf EmployedSemi Professional WorkerService IndustrySocial WorkerStudentTaxi DriverTeacherTradesman / ArtisanTuck ShopUniformed Worker / SecurityUnknown / OtherVegetable Seller
32. How many years have you been working here —Please choose an option—Less than one (1) year1 to 3 years3 to 5 yearsmore than 5 years
33. Employers Name
34. Employers Telephone Number
83%
35. A copy of your ID document
36. Proof of residence (utility bills etc.)
37. Your latest payslip
38. 3 months’ Bank Statements with official bank stamp (not older than 6 months) Month 1: Month 2: Month 3:
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100%
