Tlalane

Central Motors | Used Car Dealer | Used Cars for sale in Rustenburg
Tlalane
Sales Executive

COMPLETE THE ONLINE CAR FINANCE APPLICATION

PERSONAL DETAILS:
Title

Full Names *

Last Name *

Initials

ID Number *

Dependents

Sex

Marital Status

Date Married

E-mail Address *

Tel: (H)

Tel: (W)

Cell Number *

Home Address

Period

Postal Address

Postal Code

Previous Address

Period

Spouse Names

Spouse ID

Next of kin

Relationship

Address of Kin

Contact Number

BOND DETAILS:
Bond Holder

Bank

Outstanding Amount

Date Purchased

Registered Under

Renting Amount

EMPLOYER DETAILS:
Employer

Occupation

Employer Address

Company Tel

No. of Years

Salary Date

Previous Employer

No. of Years

Spouse Employer

Occupation

Employer Address

Company Tel

No. of Years

BANK DETAILS:
Name of Account Holder

Account Type

Bank Name

Branch Name

Branch Code

TRADE REFERENCE:
Branch

Account Number

Installments

Paid / Current / Settled / To Be Settled

Branch

Account Number

Installments

Paid / Current / Settled / To Be Settled

ETHNIC GROUP:
Race

Language

PERSONAL APPLICATION:
Salary Details: (Own) R

Salary Details: (Spouse) R

Basic Monthly (Excl. Car Allowance): (Own) R

Basic Monthly (Excl. Car Allowance): (Spouse) R

Car Allowance: (Own) R

Car Allowance: (Spouse) R

Total Salary (Basic + Car) (Own) R

Total Salary (Basic + Car) (Spouse) R

Monthly Commission (Own) R

Monthly Commission (Spouse) R

Net Take Home Pay (Own) R

Net Take Home Pay (Spouse) R

Income other than Salary/Wages ** (Own) R

Income other than Salary/Wages ** (Spouse) R

Sources of other Income ** (Own) R

Sources of other Income ** (Spouse) R

Total Monthly Household Income
(Net Salary & Other) R

HOUSEHOLD EXPENSES PER MONTH:
Bond Repayment / Rent R

Rates, Water & Electricity R

Vehicle (Excluding those to be settled) R

Personal Loan Repayments R

Credit Card Repayments R

Furniture Account Repayments R

Clothing Account Repayments R

Overdraft Account Repayments R

Policy / Insurance repayments R

Telephone Account Repayments R

Transport cost Payments R

Food & Entertainment Budget R

Education Cost Payments R

Maintenance & Repair Payments R

Other Household Expenses R

Other Expenses & Payments R

Total Monthly Household Expenses R

Household Surplus / Disposable Income R

Are you currently Liable as:

Specify Details

If you have signed Surety or Co-Debtor, Please indicate the full amount Outstanding R

I Confirm that:

A. I am not a minor.
B. I have never been declared mentally unfit by a court.
C. I am not subject to an administration order.
D. I do not have any current application pending for debt restructuring or alleviation.
E. I do not have any current debt re-arrangement in existence.
F. I have not previously applied for a debt re-arrangement.
G. I am not under sequestration.
H. I do not have applications pending for credit, nor open quotations as envisaged in section 92 of the National Credit Act.

I. If any of the above is incorrect, give details:

DECLARATION BY CLIENT:
* I hereby grant the Credit Provider the right to communicate with me through any electronic/written media or verbally in order to make available to me, their product offering.

YESNO

* I hereby grant the Credit Provider the right to increase my Credit Limit once every year to accommodate any Value Added Products needed and requested by me.

YESNO

* I hereby give consent to the Credit Provider to make enquiries about my credit record with any credit agency and to obtain whatever information on me they might require to process the application. I also give consent to the Credit Provider to share my payment behavior with any credit agency.

YESNO


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