Finance Application Form
Auto Market
Tel:(011) 789 4653 / (011) 787 2004/1093
Fax:
(011) 886 5302
Personal Information:
Title: Name:  
Surname:
ID No: Cell No:  
Home no:
Work no:  
Email:
Residential Address:


Postal Address:
Previous Residential Address:


Postal code of Residence:  
Ethnic Group:
Duration at current adress:  
Duration at prev adress:
Employment Information:
Employer's Name:
Type of Industry:
Employment no:        
Occupation:
Previous Employer's Name:          
R
Current Salary: R Car Allowance: R
Total Income/Mont: R
Home Ownership Details:
Name of relative:
Contact Number:
Do You Have Your Own Home? Yes No
Is it in your name? Yes No
Monthly Rent / Bond: R
Stand no:
Suburb:
Purchace Price: R
Purchace Price: R
Date of Purchase:
Current Value: R
Current Bond: R
Bondholder:
Spouse's Information:
Maritial Status: Spouse's Name:
Salary:
Occupation: Marriage date:
ID No:
Employer:  
No.of Dependant Children:
Vehicle You Intend To Purchase:
         Model:    Year:     Colour:
Dealer: Vehicle Price: R
Deposit/Trade In: R
Bankers Detail:
Do you have a Credit Card? Yes No
Credit Card number:
Type of Card:
Account Type:
Account No: Branch:
Branch Code:
Vehicle Insurance:
Do you have a Insurance? Yes No
With Whom:
Insurer's Phone: Policy Number:
Broker name
Inception Date: NCB:
Insured value: R
Please Complete then print and fax back to us: