Hosted Finance Application

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I understand that the details captured in this application may be sent to one or more financial institutions and I consent to Credit Bureau processing of credit information, including income, employment, personal data for prescribed business as per related Acts and that such outcome may be shared with the 3rd Party.

YES NO

Required fields are indicated by *

Item Description

Serial Number

Item Code

Purchase Price

Quantity

Notes

Required fields are indicated by *

Add

Id	Existing Contact Persons	Relationship	Regular Driver

Required fields are indicated by *

EMPLOYMENT DETAILS

Employment Type

Employer Name

Business Name

Date Of Inception

Joining Date

Trade License Number

Trade License Expiry Date

SALARY DETAILS

Basic Monthly Salary

Net Monthly Salary

Other Income

Total Expenses

ACCOUNT DETAILS

Bank Name

Branch Name

Branch Code

Account Number

Account Type

Please be advised that in order for us to complete the final assessment of your application we will need the following documents:

1. A copy of your rsa id
2. 3 months bank statements (6 months if self-employed)
3. Most recent proof of address
4. Most recent payslip or proof of income (letter from your accountant or ita34 certificate if self-employed)

documents to be scanned. No photos of supporting documents will be accepted.

Add

Id		Date	Category	Description	File Name	File Type	File Size	User

Required fields are indicated by *

I am insolvent

YES NO

I am currently under debt review

YES NO

I am currently liable as a guarantor/surety

YES NO

I am a member/shareholder in a legal entity

YES NO

Required fields are indicated by *

Consent to share details within company

YES NO

Consent to share details amongst partners

YES NO

Consent to receive marketing information

YES NO

Finance Application

We have successfully received your application. An email has been sent to your specified email address with a reference number. A representative will be in contact shortly.

Note: If you can't find the email, please check your Spam or Junk E-Mail folder just in case the email got delivered there instead of your inbox. If so, select the particular email and mark it Not Spam, which should allow future messages to get through.

Finance Application

You might not be ready or it may not be the right time to share your personal information to start a finance process. Please come back again once you are ready to provide the required information to process the finance application.