Application for Instalment Finance
1 - Personal Details
Title
Dr
Mr
Mrs
Ms
Miss
Select your title. Example: Mr.
Full Names
Enter all your names (excluding your surname). Example: Joe
Surname
Enter your surname. Example: Smith
ID No.
Enter your 13-digit South African ID number. Example: 1234567890123
Initials
Enter your initials. Example: J.
Gender
Female
Male
Select your gender
Contact Details
Tel (H)
Enter your home telephone number. Example: (021) 123 4567
Tel (W)
Enter your work telephone number. Example: (021) 123 4567
Cell
Enter your cellphone number. Example: (082) 123 4567
Fax
Enter your fax number. Example: (021) 123 4567
Email
Enter your primary email address. Example: jsmith@someplace.com
Addresses
Home Address
Enter your home address.
Example: House No 2
Water Crescent Street
Cape Town
Period at Current Address
Enter the number of years spent at your current home address. Example: 3
Previous Address
Enter your previous home address.
Example: House No 1
Water Crescent Street
Cape Town
Period at Previous Address
Enter the number of years spent at your previous home address. Example: 4
Postal Address
Enter your postal address.
Example: P.O. Box 123
Cape Town
Postal Code
Enter the post office postal code. Example: 8000
Other
Ethnic Group
African
Coloured
Indian
White
Select your ethnic group.
« select language from the list
Language Preference
Afrikaans
English
Other
Select your preferred language. If is isn't listed, choose 'Other' and type it.
Dependants
Enter the number of people depending on you (eg. children). Example: 2
Marriage Status
ANC
COP
Single
Widowed
Select your marriage status. Community of Property has extra fields than need to be completed.
Marriage
Date Married
Enter the date you were married. Example: 2000-12-24
Spouse Names
Enter the names of your spouse (excluding surname). Example: Jane
Spouse ID
Enter the valid 13-digit South African ID of your spouse. Example: 1234567890123
Next of Kin
Next of Kin - Name
Enter the name of your next of kin, someone not living with you. Example: David Smith
Next of Kin - Relationship
Enter the type of relationship. Example: Father
Next of Kin - Address
Enter the home address of your next of kin.
Example: House No 3
Sunrise Street
Johannesburg
Next of Kin - Contact Number
Enter the contact number of your next of kin. Example: (011) 123 4567
2 - Bond Details
Bond Holder
Enter the name of the bank where your bond is held.
Example: ABSA
Amount Outstanding
Enter the amount of money outstanding on your bond.
Example: 1 000,00
Property Value
Enter the total value of your property.
Example: 1 000 000,00
Monthly Instalment
Enter your monthly bond repayment value.
Example: 3 000,00
Purchase Price
Enter the amount of money you paid to buy your house.
Example: 1 000 000,00
Date Purchased
Enter the date you purchased the property.
Example: 2000-01-24
3 - Employer Details
Current Employer
Employer
Enter the name of your employer.
Example: SA Breweries
Occupation
Enter the type of work you do
Example: Chief Executive Officer
Employer Address
Enter your postal address.
Example: P.O. Box 123
Cape Town
Tel
Enter your employers office telephone number.
Example: (021) 123 4567
No. of Years
Enter the number of years you have been working for your employer.
Example: 10
Salary Date
Enter the day of the month you receive your next paycheck.
Example: 2013-12-25
Spouse Employer
Spouse Employer
Enter your name of your spouses employer.
Example: SABC
No. of Years
Enter the number of years your spouse has been working for their employer.
Example: 7
Tel
Enter the office telephone number of your spouses employer.
Example: (021) 123 4567
Occupation
Enter the type of work your spouse does for their employer.
Example: Journalist
Previous Employer
Previous Employer
Enter the name of your previous employer.
Example: KWV
No. of Years
Enter the number of years you worked for your previous employer.
Example: 3
4 - Bank Details
Branch Code
Enter the 6 digit branch code for the bank you will be using to make payments from. It will be validated.
Example: 123456
Bank Name
Enter the name of your bank.
Example: ABSA
Branch Name
Enter the name of the banks branch where your account is held.
Example: Cape Town
Name of Account Holder
Enter the name of the person who is the primary account holder.
Example: Joe Smith
Account No.
Enter your bank account number here. It will be validated.
Example: 123456789
Account Type
Credit Card
Savings
Transmission
Current
Select the type of bank account this is.
5 - Monthly Income
My Salary Details
Basic Monthly (Excl Car Allowance)
Enter your basic monthly salary. Make sure this doesn't include your car allowance.
Example: 25 000,00
Car Allowance
Enter your monthly car allowance.
Example: 2 000,00
Total Salary (Basic & Car Allowance)
This is the automatically calculated sum of your 'Basic Monthly' and 'Car Allowance'.
Monthly Commission
Enter your monthly commission.
Example: 10 000,00
Net Take Home Pay
Enter the monthly amount of money you get paid after tax deductions etc.
Example: 20 500,00
Income other than Salary/Wages
Enter the monthly amount of money you get from other sources (eg. mutual fund).
Example: 2 000,00
Spouse Salary Details
Basic Monthly (Excl Car Allowance)
Enter your spouses basic monthly salary. Make sure this doesn't include your spouses car allowance.
Example: 25 000,00
Car Allowance
Enter your monthly car allowance.
Example: 2 000,00
Total Salary (Basic & Car Allowance)
This is automatically calculated sum of your spouses 'Basic Monthly' and 'Car Allowance'.
Monthly Commission
Enter your spouses monthly commission.
Example: 2 000,00
Net Take Home Pay
Enter the monthly amount of money your spouse gets paid after tax deductions etc.
Example: 20 500,00
Income other than Salary/Wages
Enter the monthly amount of money your spouse gets from other sources (eg. mutual fund).
Example: 2 000,00
Other
Source of Other Income
Enter the source(s) of other income.
Example: Mutual Fund
Total Monthly Household Income (Net Salary & Other)
Automatically calculated sum of your Net Take Home Pay and Income other than Salary/Wages
6 - Monthly Expenses
Bond Payment / Rent
Enter how much money you pay every month to pay off your bond or how much rent you pay.
Example: 10 000,00
Vehicle instalments (Excluding Those To Be Settled)
Enter the monthly amount you must pay to pay off your car(s) .
Example: 4 000,00
Credit Card Repayments
Enter the monthly amount you must pay to pay off your credit card(s).
Example: 1 000,00
Clothing Accounts
Enter how much money you pay every month to pay off your clothing accounts.
Example: 500,00
Policy / Insurance Repayments
Enter how much money you pay every month for your car, house and other insurance/policies.
Example: 3 000,00
Transportation Costs
Enter the monthly amount you pay for petrol, car repair and public transport.
Example: 1 000,00
Education Costs
Enter the monthly amount you pay for education.
Example: 4 000,00
Household Expenses
Enter the monthly amount you pay for house repairs and renovations etc.
Example: 4 000,00
Rates, Water and Electricity
Enter how much you pay for water, electricity, rates taxes.
Example: 4 000,00
Personal Loan Repayments
Enter how much you pay every month to pay off your personal loan.
Example: 100,00
Furniture Accounts
Enter how much you pay every month to pay off your furniture account(s)
Example: 1 000,00
Overdraft Repayments
Enter the monthly amount you pay to pay off your overdraft.
Example: 1 000,00
Telephone Payment
Enter the monthly amount you pay for your telephone and/or cellphone(s).
Example: 1 000,00
Food and Entertainment
Enter how much you pay every month for food and entertainment (eg movies).
Example: 1 000,00
Maintenance
Enter the monthly amount you pay for maintenance
Example: 1 000,00
Other
Enter any other monthly expenses not already accounted for above.
Example: 0,00
Monthly Expenses
This is the automatically calculated sum total of all expenses.
Household Surplus/Disposable Income
This is an automatically calculated difference of your 'Total Monthly Income' and 'Expenses'.
Are you Surety
Are you Guarantor
Are you Co-Debtor
Liability Details
If you are liable, please enter why here.
Example: Education
Full Outstanding Surety or Co-Debtor Liability
Enter the full outstanding balance you are liable for at present
Example: 4 000,00
Preferred Method of Communication
All
Email
Post
Telephone
SMS
All
All
Email
Please select how we should contact you.
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