Application Form
This is the Finance Application Form for a Vehicle
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电子邮件地址 *
Sales Rep *
Do you have a Deposit Available? *
If Deposit is Available, How Much do you have?
Select Vehicle Below
If Vehicle is NOT listed above, Please fill in all the details here.
Do you have a clear credit record with no defaults or judgment's? *
Do you earn minimum of R 6 500 or more per month? *
Do you have a South African Barcoded ID document or ID Card? *
Do you have a valid South African Driver's License Card? *
Do you have proof of income, latest three payslips and latest three months bank statements? *
Do you have proof of your physical address not older than three months (utility bill, telephone account)? *
Title *
First Name *
Surname *
ID Number *
Date of Birth *
年
/
月
/
日
Gender *
Cell Number *
Email Address *
Marital Status *
Spouses ID Number
Spouses Contact Number (Cell)
Date of Marriage
年
/
月
/
日
How are you married *
Street Address *
Suburb *
City *
Post Code *
Province *
Years at current address *
Next of Kin (friend or relative not living with you) - First Name *
Next of Kin (friend or relative not living with you) -  Surname *
Relation *
Cell No *
Street Address *
Suburb *
City *
Province *
Post Code *
Employment Status *
Employer Name *
Nature of Business ie What work does the Business Do? *
Is the Business Registered? ie CIPC/CIPRO *
If Business is Registered and you answered YES above please enter your company registration number here
Occupation *
Employer Phone *
Years Employed *
Months Employed *
Years Previously Employed *
Months Previously Employed *
Salary Date *
Street Address *
Suburb / Area *
City *
Postal Code *
Bank Name *
Branch Name *
Branch Code *
Account Number *
Bank Account Type *
Account Holder *
Your Income Before Deductions *
Your Income After Deductions *
Your Total Expenses *
Car Allowance *
Monthly Commission *
Rental Income *
Other Income *
Bond Payment *
Rent *
Water & Lights *
Car Payments *
Personal Loan Payments *
Credit Card *
Furniture Accounts *
Clothing Accounts *
Overdraft Repayments *
Insurance Repayments *
Telephone Payments *
Transport Costs
Food & Entertainment *
Education Costs *
Maintenance Costs *
Do you have any loans with any banks? *
Are the loans up to date? *
Do you have any credit cards with any banks?
Are the credit cards up to date?
How did you hear about us? *
Where did you hear about us (Other)
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 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 or verbally in order to make available to me, their product offering. I hereby give ProWheels consent to send my finance application to it's finance origination partners for processing. 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. 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. Please accept the terms and conditions by checking yes above to continue. *
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