Finance Form

Application Form

IF THE ABOVE APPLIES TO YOU, PLEASE CALL US AT YOU SOONEST CONVENIENCE. OR COMPLETE THE APPLICATION FORM BELOW.

Goods Description

Used/New

Year

M&M Code

Term/Period

Mileage

Make

Model

F&I Contact Person

Sales Person

Cash Price VAT Incl

Licence/Reg

Warranty

Autosure

Deposit/Trade In

Vatable Extras Vat incl

Smash & Grab

Veridot

Runflat Bands

Glaze & Interior

Rate-Linked

Bluetooth Kit

Rust Stop

Other

Rate-Fixed

Personal Details

Title*

Surname*

ID Number*

Full Names*

Initials*

Date Of Marriage

Male

Female

Married ANC

Married COP

Single

Widowed

Divorced

Home Address

Tel(H)

Tel(W)

Cell*

No. of Years at

Postal Address

Previous Address

Code

Period

Spouse Names

First

Last

Next of Kin

Address

Spouse ID No.

Relationship

Tel No.

Name of Bank

Amount

Property Value

Instalment

Purchase Price

Date Purchased

Registered

Own Name

Spouse name

Renting/Boarding

Employers Details

Occupation

Employers Details

Employer Address

Years at Work

Salary Date

Previous Employer

Years at Work

Spouse Employer

Years at Work

Tel No.

Occupation

Banking Details - Applicant

Bank Name

Name Of Account Holder

Branch Name

Acc No.

Branch Code

Credit Card

Savings

Transmission

Current

Trade Reference

Branch

Account No.

Instalments

Paid Up / Current / To Be Settled

Language Preferences

English

Afrikaans (For An Explanatory Version)

Signature

Date

Applicant Initials

Surname

ID No.

YOUR INCOME DETAILS - APPLICANT (PER MONTH)

Basic Salary (Gross)

Car Allowance (Gross)

Monthly Commision (Gross)

Income Other Than Salary/Wages (Gross)

Other Household Income (Gross) Specify

Less Tax

Less Medical Aid, pension, ETC

Less Other Deductions From Salary

Nett take Home pay (A)

YOUR EXPENSES - APPLICANT (PER MONTH)

Bond Payment / Rent

Vehicle Instalments (Excl Those To Be Settled)

Credit Card Repayments

Clothing Accounts

Policy / Insurance Repayments

Transport Costs

Education Costs

Household Expenses

Sub Total

Rates, Water, Electricity

Personal Loan Repayments

Furniture Accounts

Overdraft Repayments

Telephone Payments

Food & Entertainment

Maintenance

Other Regular Payments

Total Monthly Expenses (B)

DISPOSABLE INCOME

Total Income (A)*

Total Expenses (B)*

Total Disposable Income (A) Less (B)*

Are You Currently Liable As

Surety*

Co-Debtor*

Guarantor*

Specify Details of Debt

If You have Signed Surety or Co-debtor Please Indicate The full Amount Outstanding On The Accounts:

I confirm that:

I am not a minor.
I have never been declared mentally unfit by a court.
I am not subject to an administrator 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, or open quotations as envisaged in Section 92 of the National Credit Act.
The information provided by me in this application is true and correct.

If any of the above is incorrect please give details:

Declaration by client: I hereby grant the Credit Provider the right:

To increase my Credit Limit once every year to accommodate any Value Added Products needed.
To authorise the Credit Provider to make enquiries about my credit record with any credit agency.
To obtain whatever information on me they might require to process this application.
I do not have any current application pending for debt restructuring or alleviation.

I understand that I will be liable for a monthly service fee. I also authorise the Credit Provider to share my payment behaviour with any credit agency and the National Loans Register.

Signature

Date

Are you human?*

By clicking on the SUBMIT button, I hereby consent to Kent Motors (hereafter referred to as ‘the Company) and its employees collecting and processing the Personal Information that I have provided for the purpose of enquiring about vehicles or services by the Company. I also consent to the Company retaining the Personal Information provided, in any form, for as long as the Company deems desirable, for the purpose of contacting me regarding future promotions that the Company may run. I am aware that I am able to opt out of any further communications at any time.

This field should be left blank

Application Form

Goods Description

Personal Details

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