Finance Application Step 1 of 8 – Personal InformationSalesman assisting you?Vehicle Details1. Personal InformationTitle *----Mr.Mrs.Miss.Dr.Prof.Sir.First Name *Middle NameLast Name *ID / Passport NumberDate of BirthEthnic Group----BlackWhiteIndianColoredOrientalNationality----South AfricanForeign NationalCountry if foreign nationalAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweAre you a graduate----YesNoMarital Status----Married - ANCMarried - COPMarried - Customary Law / TribalWidowedDivorcedSingleDateEmailMobile NumberLand Line NumberWork Phone NumberStep 2 of 8 – Residential Address2. Residential AddressResidential street addressSuburbCityProvince----GautengNorth WestLimpopoMpumalangaFree StateKwazulu NatalEastern CapeNorthern CapeWestern CapePostal Code0 / 4Years at addressOccupation Type----Owner - Bond FreeOwner - BondedTenantBoarderFinancial Institution – If OwnerStep 3 of 8 – Postal Address3. Postal AddressPostal AddressCityProvince----GautengNorth WestLimpopoMpumalangaFree StateKwazulu NatalEastern CapeNorthern CapeWestern CapePostal Code0 / 4Step 4 of 8 – Employment Information4. Employment InformationCompanyOccupationEmployment Type----Full-TimePart-TimeTemporaryContractInternSeasonalSelf EmployedPensionerYears at companyEmployer Street AddressSuburbCityProvince----GautengNorth WestLimpopoMpumalangaFree StateKwazulu NatalEastern CapeNorthern CapeWestern CapePostal Code0 / 4Step 5 of 8 – Expenses5. ExpensesBond Payment / RentZARCredit Card RepaymentsZARClothing AccountsZARFurniture AccountsZAROverdraft RepaymentsZARTransport CostsZAREducation CostsZARMaintenanceZARVehicle InstallmentsZARPersonal Loan'sZARFood & EntertainmentZARInsurance CostsZARRates, Water & ElectricityZARTelephone & Pre-PaidZARHousehold ExpensesZAROther CostsZARStep 6 of 8 – Income Information6. Income InformationGross IncomeZARMonthly CommissionZARCar AllowanceZAROvertimeZARNet Take-home PayZAROther IncomeZARTotalsTotal Monthly IncomeRTotal Monthly ExpensesRDate Remuneration is receivedStep 7 of 8 – Required Documents7. Required DocumentsID Doc / PassportChoose FileNo file chosenDelete uploaded fileAccepted file types: jpg, png, pdf, jpeg, Max. file size: 10 MB.Drivers LicenceChoose FileNo file chosenDelete uploaded fileAccepted file types: jpg, png, pdf, jpeg, Max. file size: 10 MB.Drivers LicenceChoose FileNo file chosenDelete uploaded fileAccepted file types: jpg, png, pdf, jpeg, Max. file size: 10 MB.Drivers LicenceChoose FileNo file chosenDelete uploaded fileAccepted file types: jpg, png, pdf, jpeg, Max. file size: 10 MB.Drivers LicenceChoose FileNo file chosenDelete uploaded fileAccepted file types: jpg, png, pdf, jpeg, Max. file size: 10 MB.Step 8 of 8 – Consent8. Consent to credit providerConsent *I/we provide my/our express consent to the credit provider to request bank statements in respect of the bank account/s listed on the application form and process my/our personal information (as defined in the legislation) for the sole purpose of applying for vehicle/asset finance.Date Accepted * Submit
