Financing Form – Just Carz

Just Carz Financing Form

Application for Installment Finance Individual

Title

First Name

Last Name

ID Number

Initials

Gender

Marital Status

Marriage Date

Home Address

Tel (Home)

Tel (Work)

Cell

Postal Address

Postal Code

First Name

Relationship

Address

Tel

Employer

Occupation

No of Years

Employer Address

Bank Name

Branch Name

Account No.

Account Holder

Type of Card

Basic Monthly Salary (Excl Car allowance)

Other Salary

Net Take Home pay

Net Pay/other

Household Expenses

Rates/Water/Electricity

Vehicle Instalment

Personal Loans

Credit Card Payments

Policy/Insurance

Telephone Payments

Transport Costs

Food/Entertainment

Total Household Expenses

Year

Make

Model

Variant

Please upload the following required documents Step

Upload a copy/photo of your ID

Upload a copy/photo of your license

Upload a copy/photo of payslip 1

Upload a copy/photo of payslip 2

Upload a copy/photo of payslip 3

Upload a copy/photo of 3 months latest bank statements

Declaration By Client 1 - I confirm that.
a. I am not a minor
b. I have never been declared mentally unfit by a court.
c. I am not subject to an administration order.
d. I do not have any current application pending for debt restructuting or alleviation.
e. I do not currently have any debt re-arrangement in existence.
f. I have not previously applied for debt re-arrangement.
g. I am not under sequestration.
h. I do not have any applications pending for credit, nor open quotations as envisaged in section 92 of the National Credit Act

If any of the above are incorrect state which, and provide details.

2 - I hereby give consent to the Credit Provider to make enquiries about my Credit Record with any credit agency and to obtain any information on me they might require to process the credit appliation/and or application for insurance, and to share my payment behaviour with any credit agency.

Please check Yes/No

Yes No

3 - I hereby declare that all the above information is true and correct.

Date