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Finance Application

Fill in and submit the form below to finance your next adventure.
Caravan Year Model Make & Model Full Name(s) Surname ID Number E-mail Cellphone Valid Drivers License Code on Drivers License Residential Address Living Status Postal Address Next of Kin (Not living at same address) Relationship to Next of kin Next of kin Contact no. Employer Occupation Tell (W) Employer Address No. of Years at current employer Salary Date Bank Name Name of account holder Account Number Account Type Basic Income Nett Income Bond Payment / Rent Personal Loan Repayments Credit Card Repayments Furniture Accounts Telephone Accounts Clothing Accounts DSTV Policy / Insurance Repayments Vehicle Installments (Excl. those to be settled)
I confirm that:
I am not a minor.
I have never been declared mentally unfit by a court.
I am not subject to an administration order.
I do not have any current application pending for debt restructuring or alleviation.
I do not have any current debt re-arrangement in existence.
I have not previously applied for a debt re-arrangement.
I am not under sequestration.
I do not have applications pending for credit, nor open quotations as envisaged in section 92 of the National Credit Act.
I hereby grant the Credit Provider the right to communicate with me through any electronic/written media of verbally in order to make available to me, their product offering.
I agree to the Terms & Conditions and Privacy Policy Submit

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