LOAN APPLICATION PERSONAL INFORMATION All fields required. Member Number *Your Member Number0 / 13 Title * Names in Full * Surname * Identification Number *Please enter a valid 13-digits South African ID number0 / 13 Email * Please upload ID Document * Drag and Drop (or) Choose Files Please upload Proof of Residence * Drag and Drop (or) Choose Files Mobile * Alternative Phone Street Address * PO Box Suburb * Suburb City * City Province * Province Postal Code * Postal Code Do you own fixed property? *Please selectYesNo If not, current living arrangements?Please selectRentLive with ParentsOther Years at present address * Language *Please selectEnglishAfrikaansSelect Language RSA Resident *Please selectYesNoOther Maritial Status *Please selectBy ante nuptial contractIn community of propertyWidow/WidowerUnmarriedDivorcedCustomary Law Number of Dependents * EMPLOYMENT DETAILS All fields required. Type of Employment *Please selectPermanentSelf-EmploymentContractedCommission EarnerPensioner Name of Employer * Work Phone Years of Service * Occupation * Employer Physical Address *(Current Employer) SPOUSE'S PERSONAL INFORMATION Required if married in community of property Spouse's Initials Spouse's Maiden SurnameIf applicable Spouse's Identification numberPlease insert a valid 13-digit South African ID number (If applicable)0 / 13 Spouse's Phone Please attach Spouse's ID document Drag and Drop (or) Choose Files If applicable AFFORDABILITY ASSESSMENT All fields required. Monthly Income Gross Salary - Applicant * ZAR Gross Salary - Spouse ZAR Other Income - Applicant * ZAR Other Income - Spouse ZAR Please specify Please specify Total Income - Applicant Total Income - Spouse Please upload Proof of Income (Applicant) * Drag and Drop (or) Choose Files Please attach 3 months latest payslips or bank statements Please upload Proof of Income (Spouse) Drag and Drop (or) Choose Files Please attach 3 months latest payslips or bank statements Payslip Deductions Medical Aid - Applicant ZAR Medical Aid - Spouse ZAR Pension / Provident Fund - Applicant ZAR Pension / Provident Fund - Spouse ZAR PAYE - Applicant ZAR PAYE - Spouse ZAR UIF - Applicant ZAR UIF - Spouse ZAR Other Deductions - Applicant ZAR Other Deductions - Spouse ZAR Total Deductions - Applicant Total Deductions - Spouse Net Salary - Application Net Salary - Spouse Monthly Expenses Accommodation Expense - Applicant * ZAR Accommodation Expense - Spouse ZAR Transport Expense - Applicant ZAR Transport Expense - Spouse ZAR Food Expense - Applicant ZAR Food Expense - Spouse ZAR Education Expense - Applicant ZAR Education Expense - Spouse ZAR Medical Expense - Applicant ZAR Medical Expense - Spouse ZAR Maintenance Expense - Applicant ZAR Maintenance Expense - Spouse ZAR Water & Electricity - Applicant ZAR Water & Electricity - Spouse ZAR Other Expenses - Applicant ZAR Other Expense - Spouse ZAR Total Expenses - Applicant Total Expenses - Spouse Accounts Asset Finance - Applicant ZAR Asset Finance - Spouse ZAR Personal Loans - Applicant ZAR Personal Loans - Spouse ZAR Credit Cards - Applicant ZAR Credit Cards - Spouse ZAR Bond Repayments - Applicant ZAR Bond Repayments - Spouse ZAR Cellphone Expense - Applicant ZAR Cellphone Expense - Spouse ZAR Micro Loans - Applicant ZAR Micro Loans - Spouse ZAR Security - Applicant ZAR Security - Spouse ZAR Insurance - Applicant ZAR Insurance - Spouse ZAR Clothing - Applicant ZAR Clothing - Spouse ZAR General Retail - Applicant ZAR General Retail - Spouse ZAR Total Accounts - Applicant Total Accounts - Spouse Min Bond Repayment - Applicant ZAR Min Bond Repayment - Spouse ZAR Disposable Income Disposable Income Total - Applicant Disposable Income Total - Spouse STATEMENT OF ASSETS Fixed Property Suburb Market Value ZAR Current Balance ZAR Suburb Market Value ZAR Current Balance ZAR Suburb Market Value ZAR Current Balance ZAR Movable Assets Description Market Value ZAR Description Market Value ZAR Description Market Value ZAR CONSENT AND SUBMISSION Bank Details For direct electronic transfers to your bank account Account Holder Name Account Number Account Type Bank Name Branch Number Please upload Account Confirmation * Drag and Drop (or) Choose Files Loan Required The applicable interest rate will be fixed Loan Amount Required Maximum repayment period The cost of credit (Interest Rate) per annum is as follows: 6 - 24 months: Fixed at the prime lending rate plus 3% 24 - 36 months: Fixed at the prime lending rate plus 4% Signed at * Date * Date application completed Signature of Account Holder * Start signing your signature here Your browser does not support e-Signature field. Debit Order approval. Cost of Credit * I agree with the membership fees as per the Cost of Credit Terms and Conditions * Yes, I agree with the privacy policy and terms and conditions. Confirmation of Application * I/we hereby confirm that I/we have answered all your questions and relevant information fully and truthfully as part of this assessment process. I/we hereby confirm that I/we have fully disclosed my/our debt repayment history Applicant's Signature * Start signing your signature here Your browser does not support e-Signature field. Spouse Signature Start signing your signature here Your browser does not support e-Signature field. If applicable SubmitSave as Draft (THIS DOES NOT SUBMIT THE FORM)
