Finance Application Form – A Family Car
– Personal Information –
Title: Name:
Surname:
ID No:    
Tel(W): Tel(H): Tel(C):
 
Email:
Residential Address: Postal Address:
Previous Residential Address:
Postal code:
Duration at: Current address: Prev address:
– Employment Information –
Employer:
Type of Industry:
Physical address of employer:
Occupation:
Duration at current employer:
Employment No: Current Salary: R
Car Allowance: R
Total Income/Month: R
Other income: R
telephone number of employer:
Previous employer:
– Reference –
Name of relative not liveing in the house:
Relationship:
Physical address of said relative:
Tel(W): Tel(H): Tel(C):
– Home Ownership Details –
Do you have your own home? Yes No
Is it in your name? Yes No
– Spouse's Information –
Marital Status:
Spouse's Name:
ID No: Date of marriage:
Occupation:
If employed, name of employer:    
Salary:
Physical address of employer:
 
Tel(W): Tel(C):
– Vehicle you are interested in –
Model:
Year: Colour:
Dealer: Vehicle Price: R
Deposit/Trade In: R
Bank Detail –
Name of bank:    
Account Type:
Account No: Branch:
Branch Code:
Do you have a Credit Card? Yes No
If Yes, with which bank:
Credit Card No:
Type of Card:
– Vehicle Finance –
Do you have vehicle finance? Yes No
With who ?
Please Complete, Print and Fax back to us: (011) 740-6495 or (011) 740-0734