Barloworld Toyota Kuilsrivier

Finance




Application for Installment Finance
Personal Details
Title *
Initials * Surname * ID No *
Full Names *
Dependants
Nationality *
Date Married
Home Address
Period
Tel (H) *
Cell * Fax
Tel (W) Email *
Postal Address *
Code
Previous Address *
Period *
Spouse Names
Spouse ID
Next of Kin
Relationship
Address
Tel
Bond Details
Bond Holder
Amount Outstanding
Property Value R
Instalment R /M Purchase Price
Date Purchased
Registered Renting R
Employer Details
Employer *
Occupation *
Industry Type *
Employers Address *
Tel * No of Years
Salary Date *
Previous Employer No of Years
Spouse Employer
No of Years
Tel
Occupation
Salary Details
  Own Spouse Other
Basic Monthly *(excl Car Allow)
Car Allowance
Total Salary Basic & Car Allow
Monthly Commision
Net Take Home Pay *
Income other than Salary
Sources of other income
Bank Details
Bank Name *
Branch * Branch Code *
Name of Account Holder * Account number *
Account Type *
Settle Existing Account * Account No. to settle
Household Income
Bond Payment / Rent Rates, Water & Electricity
Vehicle Installments Personal Loan Repayments
Credit Card Repayments Furniture Accounts
Clothing Accounts Overdraft Repayments
Policy / Insurance Payments Telephone Repayments
Transport Costs Food & Entertainment
Education Costs Maintenance
Household Expenses Other
Total Monthly Household Expenses *
Household Surplus / Disposable income *
Are You Currently Liable As: *
Specify Details *
If you have signed Surety or Co-Debtor Please Indicate the Full Amount Outstanding *
Vehicle Details
Make
Model
Variant
Year
Price
Mileage

I hereby give consent to the credit provider to make enquiries about my credit record with any credit agency and to obtain whatever Information on me they might require to process the application and obtain an insurance quote.

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

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Personnel
EmailPositionPhoneMobile
 
Leon GobregtsAutomark Business Manager021 900 3115078 872 2949Photo
Werner Janse van RensburgF&I Manager021 900 3131 076 392 4119Photo
Xolelwa MasizaF & I Assistant021 900 3123083 369 0566Photo
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