Finance Application

Personal Information

Client Type

Title

Initials

First Name

Last Name

ID Number

Date of Birth

Primary Language

Marital Status

Marriage Type

Date Married

Home Address

Address Line 1

Address Line 2

City

Province

Zip Code

Residential Status

Time at Address (Years)

Mobile Number

Tel (W)

Tel (H)

Email Address

Next of Kin (Name & Surname)

Next of kin (Contact Number)

Next of Kin (Relationship)

Next of Kin Address

Address Line 1

Address Line 2

City

Province

Zip Code

Employer Details

Employer

Occupation

Salary Date

Year at Company

Company Address

Address Line 1

Address Line 2

City

Province

Zip Code

Banking Details

Bank Name

Account Number

Account Type

Trade In or Cash Deposit

Trade in

Settlement Amount (Trade In)

Finance House

Cash Deposit

Cash Deposit Amount

Income

Gross Income

Net Income

Expenses

Bond/Rent Payment

Vehicle Instalments (Excl to be settled)

Clothing Accounts

Policies/Insurance Payments

Transport Costs

Education Costs

Houshold Expenses

Rates, Water & Electricity

Personal Loans

Furniture Accounts

Overdraft

Cellphone Payments

Food & Entertainment

Maintenance

Other