Sales Representative Sales Representative (Not Required) ABEDNIGO MALATJI DEIDRE LUDICK ELMAY LUDICK FRANCOIS LUDICK RUAN VAN WYK

Which Vehicle (ie 2010 2.0) -SELECT- 2022 White Renault Triber 2020 White Nissan NP200 2011 White Toyota Fortuner 2019 Orange Ford Fiesta 2011 White Volkswagen Jetta 2015 White Volkswagen Polo Vivo 2015 Orange BMW 3 Series 2021 Silver Toyota Corolla 2015 Yellow Renault Megane RS 2020 Silver Volkswagen Polo 2019 White Ford Figo

Personal Details

Title Not Selected Advocate Doctor Mr Miss Mrs Reverend Professor

Surname

Full Names

Cell Number

Email Address

Sex - Male Female

ID Number

No. Of Dependants

Marital Status Not Selected Divorced Married Single – Adult Single - Young Widow/er

Marital Contract Not Selected Antenuptual Contract In Community of property Traditional Marriage Married in COP (Chapter 2 & 3) Married in COP ( not Chapter 2 & 3) Foreign/Custom

Date of Marriage (dd/mm/yyyy): DAY   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 DAY MONTH   1 2 3 4 5 6 7 8 9 10 11 12 YEAR   1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Home Address

Street 1:

Street 2:

Street 3:

Suburb :

City :

Postal Code:

How long have you stayed at this address? (Years/Months):

Postal Address

Postal Address:

P.O. Box 1 :

P.O. Box 2 :

P.O. Box 3 :

P.O. Box Suburb :

P.O. Box City :

P.O. Box Postal Code :

Telephone(Home):

Telephone(Work):

Spouse Name(if Married):

Spouse ID(if Married):

Spouse Cell Number(if Married):

Details of Somebody NOT Living With You

Name:

Surname:

Cell Number:

Relationship - Friend Family Boss

Address:

Employer Details

Employers Company Name:

Managers Name:

Occupation Not Selected AGRICULTURE BUILDING AND CONSTRUCTION BUSINESS SERVICES COMMERCE COMMUNITY SERVICE EDUCATIONAL SERVICES - PRIVATE ELECTRICITY,GAS AND WATER ENTERTAINMENT/SPORTS/RECREATION ESCOM FINANCIAL GOVERNMENT INFORMATION TECHNOLOGY MANUFACTURING MEDICAL SERVICES - PRIVATE MINING NON-PROFIT ORGANISATIONS PERSONAL SERVICES RETAIL TELKOM TRANSPORT/STORAGE/COMMUNICATION UNKNOWN

How long have you worked there?:

Employers Address:

Employers Telephone:

What date do you get paid:

Banking Details

Who do you Bank With? Not Selected ABN AMRO BANK ABSA BANK ABSA-ITHALA AFRICAN BANK AL BARAKA ALPHERA FINANCE AUDI FINANCIAL SERVICES BANK OF ATHENS BANK WINDHOEK BIDVEST BANK BMW FINANCE BOE BANK (NEDBANK) CAPITEC BANK CITIBANK FBC FIDELITY BANK LTD FIRST NATIONAL BANK GRINDROD BANK HABIB OVERSEAS BANK HBZ BANK INVESTEC BANK LIMITED MERCANTILE BANK NBS (NEDBANK) NEDBANK NEDBANK (Lesotho) NEDBANK (Namibia) NEDBANK (Swaziland) OTHER PEP BANK (NEDBANK) RESERVE BANK SA BANK OF ATHENS SA POST OFFICE STANDARD BANK STANDARD BANK (SWAZILAND) STANDARD CHARTERED BANK (20TWENTY) STANDARD LESOTHO BANK LIMITED TEBA BANK TOYOTA FINANCIAL SERVICES UNIBANK LIMITED VOLKSWAGEN FINANCIAL SERVICES WESBANK

Type of Account? - Cheque Transmission Savings

Bank Branch Name?:

Bank Account Number?

Bank Branch Number?

Name of Account Holder

Income and Expenses

Total Income Before Deductions

Total Income After Deductions

Total Expenses ie Rent, Vehicles, Food, Telephone, Electricity, etc

Breakdown of Expenses

Bond Payment / Rent

Rates, Water, & Electricity

Vehicle Installments

Personal Loan Repayments

Credit Card Repayments

Furniture Accounts

Clothing Accounts

Overdraft Repayments

Insurance Repayments

Telephone Payment

Transport Costs

Food and Entertainment

Education Costs

Maintenance

Household Expenses

Other

By checking the check box below I hereby give consent to the Credit Provider to make enquiries about my credit record with any of credit agencies and to obtain whatever information on me that they might require to process the credit application and / or application for insurance. I hereby declare that all of the above information is true and correct . I also consent to all related parties for the collection and use of this information. *