Finance Application

APPLICATION TYPE:

Type of application

ID / Passport No.

Transaction Type

Language Preference

Ethnic Group

APPLICANTS DETAILS:

First Name

Last Name

Title

Gender

Initials

Graduate (degree)

Trading as Name

Email

Phone/Mobile

Address

Address Line 1

Address Line 2

City

Code

How long have you been in your current address?

Postal Address same as Physical

Yes

No

Postal Address

PO Box

Suburb

Province

Postal Code

How long have were you at your previous home address?

MARITAL DETAILS :

Marital Status

Date Married

If Married - select under what legal contract

Spouse's Details:

First Name

Last Name

Spouse's ID No.

Spouse's Employer Name

Spouse Employer Address

Address Line 1

Address Line 2

City

Code

RELATIVE DETAILS: (Nearest relative in SA, not living with you)

First Name

Last Name

Relationship to applicant

Phone/Mobile

Relatives Address

Address Line 1

Address Line 2

City

Code

EMPLOYMENT DETAILS

Employers Name

Employers Address

Address Line 1

Address Line 2

City

Province

Area Code

Employers Contact Number

Industry

Occupation

How long were you in your pervious job?

HOME OWNERSHIP

Do you own your Property?

If Yes - What date was it purchased?

If Yes - In whose name was it purchased?

Property purchase price

Bond amount outstanding

Current Value of property

Bond Holder

APPLICANT'S BANKING DETAILS

Bank Name:

Branch Code:

Account No.:

Account Type

Account Holders Name :

Overdraft Limit:

APPLICANT'S INCOME DETAILS:

Gross Remuneration

Monthly Commission

Car Allowance included in gross

Net Take-Home Pay

Income other than Salary / Wages

Source of other income

Total Monthly Income

Applicant's Expenses per Month:

Personal Loan Repayments

Vehicle Instalments (Excluding those to be settled)

Policy/Insurance/Medical Aid Payments

Rates, Water & Electricity

Bond Payment / Rent

Credit Card Repayments

Furniture Accounts

Clothing Accounts

Overdraft Repayments

Telephone (Pre-paid, contract & Telkom)

Transport Costs (Petrol/Diesel/Taxi)

Food & Entertainment

Education

Household expenses (Wages)

Other (Maintenance, DSTV, Gym, Alarm etc)

TOTAL MONTHLY EXPENSES

Applicant's Disposable Income

Preferred Debit Order Date

EXISTING AND / OR PREVIOUS VEHICLE FINANCE ACCOUNTS

ACCOUNT 1

Credit Provider Name:

Account Number:

Installment Per Month:

Is this account still open?

Account to be settled as part of this transaction?

ACCOUNT 2

Credit Provider Name:

Account Number:

Installment Per Month:

Is this account still open?

Account to be settled as part of this transaction?

TRANSACTION DETAILS

Vehicle Make

Vehicle Model

Year Model

Sales person

Purpose of Goods

Selling Price (INCL VAT)

Initiation Fees to be financed

LESS Deposit amount

Source of Deposit:

Total Amount

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 rearrangement.
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 statements are incorrect, state which and give details below:

I would like to be included in any Telemarketing Campaign

I would like to be included in any Marketing List that you may sell or distribute.

I would like to be included in any mass distribution of e-mails or SMS messages.

I confirm that all permissions are given to Street Smart Financial Solutions (Pty) Ltd in terms of POPIA compliance and IDX bank statement consent
I confirm that my details can be shared between Street Smart Financial Solutions Pty Ltd (t/a Street Smart Finance) and the dealer involved in the transaction (if applicable)
I hereby 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.

Numeric Field

I consent to have this website store my submitted information so they can respond to my inquiry

083 266 2310 (National)

071 856 6867 (National)

082 377 0255 (KZN Only)