Postal Address (Leave blank if same as physical address.)
Street,House
Suburb
City
Province
Postal Code
Application
Please provide proof of address.
Application
Bank Details
Bank Name
Branch Code
Account Number
Account Type
Account Opened For
Application
Please provide latest 3 months bank statements.
Application
Employment
Employer Name
HR Number
HR E-Mail
Employment Details
Employment Type
Payment Frequency
Payment Method
Payday
Application
We would love to give you some money but we need to make sure that we are responsible in loaning you the money. In order for us to properly ensure that you can afford the loan, we need some of your financial information below.
Monthly Income
Monthly Salary
Other Income
Total Income - R0.00
Monthly Expenses
Rent / Bond
Utilities (Water & Lights)
Vehicle Payment
Groceries
Other
Total Expenses - R0.00
Application
Your Details
Name
ID Number
Bank Details
Bank Name
Branch Code
Account Number
Account Type
Loan Details
Loan Amount
Term (Until Payday)
Repayment Estimate
Repayment Date
I hereby agree that all the information that was provided in the application form is true and correct.
By ticking of the tickbox "I Confirm and Accept" each declaration listed in Declarations.