Finance Application Form

Wish List

Vehicle Interested in?

Please enter the vehicle you are interested in.

Instalment Budget

Please enter a valid budget.

Residual / Balloon?

Please enter residual/balloon value.

Applicant Type

ID/Passport No:

Please enter a valid ID/Passport number.

Country of Residence

Please enter your country of residence.

Permit Type

Please enter your permit type.

Language Prefer:

English

Afrikaans

Other

Please select your preferred language.

Ethnic Group:

A

B

C

W

Please select your ethnic group.

Citizenship:

SA

Other (if not SA resident, state country of Residence)

Please select your citizenship.

Applicant’s Details

Surname:

Please enter your surname.

Full Name/s:

Please enter your full name.

Gender:

M

F

Graduate?

Yes

No

Home Tel No:

Please enter a valid home telephone number.

Cell No:

Please enter a valid cell number.

E-mail Address:

Please enter a valid email address.

Home Address:

Please enter your home address.

Suburb:

Please enter your suburb.

Postal Code:

Please enter a valid postal code.

Period at Address: Years

Please enter the number of years at your address.

Months

Please enter the number of months at your address.

Marital Details:

S

M

D

W

Please select your marital status.

Date Married:

Please select your date of marriage.

ANC

COP

OTHER

Please select your marriage type.

Spouse's Details

Surname:

Please enter your spouse's surname.

Full Name/s:

Please enter your spouse's full name.

Spouse’s ID No:

Please enter your spouse's ID number.

Property Details

Do you Rent the Property?

Yes

No

Do you own Property?

Yes

No

Bonded By which Bank:

Please enter the bank you are bonded by.

If Yes:

Your Name

Your Spouse

Both

Employment Details

If Self Employed, Nature of Business:

Please enter the nature of your business.

Company Name:

Please enter your company name.

Company Address:

Please enter your company address.

Suburb:

Please enter the suburb of your company.

Postal Code:

Please enter a valid postal code for your company.

Landline Number:

Please enter a valid landline number.

HR No:

Please enter a valid HR number.

Occupation:

Please enter your occupation.

Industry:

Please enter your industry.

Period at Employer: Years

Please enter the number of years at your employer.

Months

Please enter the number of months at your employer.

Salary Date:

Please select your salary date.

Retrenchment Notice in last 6 months?

Yes

No

Please select if you have received a retrenchment notice.

Applicant's Income Details

Gross Remuneration (Before deductions) R

Please enter your gross remuneration.

Monthly Commission (Included in Gross Salary) R

Please enter your monthly commission.

Car Allowance (Included in Gross Salary) R

Please enter your car allowance.

Net Take-home Pay (After Payslip Deductions) R

Please enter your net take-home pay.

Income other than Salary R

Please enter other income details.

Source of Other Income:

Please enter the source of other income.

Total Monthly Income R

Please enter your total monthly income.

Applicant's Expenses per month

Personal Loan Repayments R

Please enter your personal loan repayments.

Vehicle Instalments (excl those to be settled) R

Please enter your vehicle instalments.

If Settling your Vehicle, Can we draw a Settlement Letter?

Yes

No

Please select if we can draw a settlement letter.

Policy/ Insurance Repayments R

Please enter your policy/insurance repayments.

Rates, Water and Electricity R

Please enter your rates, water, and electricity expenses.

Bond Payment / Rent R

Please enter your bond payment or rent.

Credit Card Repayments R

Please enter your credit card repayments.

Furniture Accounts R

Please enter your furniture account repayments.

Clothing Accounts R

Please enter your clothing account repayments.

Overdraft Repayments R

Please enter your overdraft repayments.

Telephone Payment R

Please enter your telephone payment.

Transport Costs R

Please enter your transport costs.

Food and Entertainment R

Please enter your food and entertainment expenses.

Education Costs R

Please enter your education costs.

Spousal / Child Support R

Please enter your spousal or child support payments.

Household Expenses R

Please enter your household expenses.

Other R

Please enter any other expenses.

Total Monthly Expenses R

Please enter your total monthly expenses.

Banking Details

Account Holder:

Please enter the account holder's name.

Bank Name:

Please enter the bank name.

Branch Code:

Please enter a valid branch code.

Account No:

Please enter a valid account number.

Account Type:

Cheque

Savings

Other

Please select your account type.

Relative’s Details (Relative in SA NOT living with you)

Surname:

Please enter your relative's surname.

Full Name/s:

Please enter your relative's full name.

Home Address:

Please enter your relative's home address.

Cell No:

Please enter a valid cell number for your relative.

Relationship:

Please enter your relationship with the relative.

IDX - CONSENT TO ELECTRONICALLY OBTAIN ACCOUNT STATEMENTS FORM FINANCIAL INSTITUTION

For the purpose of assessing the finance application that the Du Toit Motors dealer will submit on your behalf to any or all of the Banks. The Banks need your consent to obtain your bank statement(s) directly from other financial institutions (as specified below). The Banks will exchange only the bank statements you have authorised and these will be safeguarded and not used for any other purpose other than the finance application for which you have consented. Bank account statements obtained will also be limited to the period necessary to assess the finance application.

Name of Bank

Please enter the name of the bank.

Account Number

Please enter a valid account number.

Account Type

Please enter the account type.

Branch Number

Please enter a valid branch number.

Branch Name

Please enter the branch name.

Signature:

Please provide your consent signature.

3 Months Payslip

Upload Payslip 1:

Upload Payslip 2:

Upload Payslip 3:

3 Months Bank Statement

Upload Bank Statement 1:

Upload Bank Statement 2:

Upload Bank Statement 3:

DOCUMENTS

To be submitted with application

ID DOCUMENT:

DRIVERS LICENCE:

PROOF OF ADDRESS:

Declarations

I confirm that:

I am not a minor.
I have never been declared mentally unfit by a court.
I am not subject to an Administration 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 applications pending for credit, nor open quotations as envisaged in section 92 of the National Credit Act.

If any of the above is incorrect, state which and give details:

I understand that I will be liable for a monthly service fee.

I hereby 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 in compliance with this Credit Provider’s obligation under the National Credit Act.

I hereby declare that the information provided by me is true and correct.

Signature of Applicant:

Please provide your signature.

Date:

Please select the date of signing.

Du Toit Motors

Individual Application for Finance

Wish List

Applicant Type

Applicant’s Details

Spouse's Details

Property Details

Employment Details

Applicant's Income Details

Applicant's Expenses per month

Banking Details

Relative’s Details (Relative in SA NOT living with you)

IDX - CONSENT TO ELECTRONICALLY OBTAIN ACCOUNT STATEMENTS FORM FINANCIAL INSTITUTION

3 Months Payslip

3 Months Bank Statement

DOCUMENTS

Declarations