Finance Application - Peter Vehicle Sales | Vehicle Finance Application Form

Personal Details

ID Number

Name(s) & Surname

Date of Birth

Physical Address

Telephone Number (Work)

Telephone Number (Home)

Cell Number

Years at Address

Months at Address

Email Address

Postal Address

Graduate

Yes No

Employment Details

Business Address

Employer

Occupation

Years Employed

Months Employed

Marital and Property Details

Marital Status

Single Married Widowed Divorced

Date Married

Marriage Type

COP ANC

Property Status

Owner Tenant Lodger

Name & Surname (Property Owner)

Property Value (Owner)

Cell Number (Property Owner)

Financed By

Address (Financed Property)

Outstanding Value

Paid Up in Full

Next of Kin

Name & Surname

Relationship

Cell Number

Banking Details

Bank Name

Account Type

Current/Cheque Savings

Debit Order

1st of Month 15th of Month 30th of Month

Account Number

Branch Name

Branch Code

Income & Expenditure

Gross Income

Commission

Car Allowance

Net Income

Other Income

Bond / Rent

Rates / Water / Lights

Vehicle Repayments

Personal Loans

Credit Card Payments

Furniture Accounts

Clothing Accounts

Insurance Policies

Telephone Payments

Landline Mobile Phone Pre-Paid

Transport Costs

Food & Entertainment

Education Costs

Maintenance

Household Expenses

Existing Account to be Settled

Yes No

Bank (for Settlement)

Settlement Amount

Vehicle Details

Vehicle Type

Kilometres

Make

Model

Year

Finance Period (Months)

72 60 54 48 36 24 12

Price

Licence & Registration

Service & Delivery

Smash & Grab Safety Tint

Metallic Paint

Tracking Device

Deposit

Warranty/Maintenance Plan

Declarations and Consents

I confirm that I am not a minor I have never been declared mentally unfit by a court I am not subject to an administrative order I do not have any current application pending for debt restructuring or alleviation I do not have any current debt re-arrangement in existence I have not previously applied for a debt re-arrangement I am not under sequestration I do not have any applications pending for credit, nor open quotations as envisaged in section 92 of the National Credit Act

Telemarketing

Yes No

Marketing List

Yes No

Mass Distribution

Yes No

I understand that I will be liable for a monthly service fee I consent to this Credit Provider making enquiries regarding my credit history with any credit bureau I consent to this credit provider reporting the conclusion of any credit agreement with me to the National Loans Register I hereby declare that the information provided by me is true and correct I consent to my details being made available to personnel within IPOP and authorize them to act on my behalf

Individual Application for Finance

Personal Details

Employment Details

Marital and Property Details

Next of Kin

Banking Details

Income & Expenditure

Vehicle Details

Declarations and Consents