Apply For Financing

Trade References Company 1

Trade References Company 2

Trade References Company 3

Trade References Company 4

Household expenses per month (Only use numbers in Rand value and no spaces)

Household Income Details


1. I have never been declared mentally unfit by a court.

2. I am not subjected to an administration order or under sequestration.

3. I do not have any current application pending for debt restructuring or alleviation.

4. I do not have any current debt rearrangement in existence.

5. I have not previously applied for debt rearrangement.

6. I do not have applications pending for credit, nor open quotations as envisaged in section 92 of the national credit act.


I clarify that all the above information is true and correct and grant approval to the credit grantor to make any enquiries about my credit record with any credit agency and to obtain whatever information on me that they might require to process this application.

Send us a message