2012 TOYOTA VERSO 1.8 TX

R174,900.00

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First Name
Surname
Email
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Friend's Name*

Your Email*

Friend's Email*

Message
Financial Form
Financial Form
Salesman assisting you?
1. PERSONAL INFORMATION
Title
First Name
Middle Name
Surname

ID / Passport Number
Birth Date...

Ethnic Group
Nationality
Country if foreign National

Graduate
Marital Status
If Married (Date Married)
Email Address

Mobile Number
Land Line Number
Work Phone Number
2. RESIDENTIAL INFORMATION
Residential Street Address

Suburb
City

Province
Postal Code
Years at Address

Postal Address

City
Province
Postal Code

Occupation Type
Financial Institution - If Owner

3. EMPLOYMENT INFORMATION
Company
Occupation
Employment Type
Years at Company

Employer Street Address

Suburb
City

Province
Postal Code

4. INCOME INFORMATION
Gross Income
Monthly Commission
Car Allowance

Overtime
Net Take-home Pay
Other Income

5. EXPENSES
Bond Payment / Rent
Credit Card Repayments
Clothing Accounts

Furniture Accounts
Overdraft Repayments
Transport Costs

Education Costs
Maintenance
Vehicle Installments

Personal Loan's
Food & Entertainment
Insurance Costs

Rates, Water & Electricity
Telephone & Pre-Paid
Household Expenses

Other Costs

6. FRIEND / FAMILY INFORMTION (NOT RESIDING WITH YOU)
Name
Surname

Relationship
Phone Number

Relative Residential Street Address

Suburb
City

Province
Postal Code

7. BANKING INFORMATION
Bank Name
Account Number
Account Type

8. TRADE-IN DETAILS
Are you trading in a vehicle?
Do you need to settle the vehicle?

Trade-in Vehicle Bank Name
Account Number to Settle
Amount To Settle

9. Required Documents
ID Doc / Passport
Drivers Licence

3 Months Payslips
3 months Bank statements

Proof of address (not older than 3 months)

CONSENT TO CREDIT PROVIDER

I/we provide my/our express consent to the credit provider to request bank statements in respect of the bank account/s listed on the application form and process my/our personal information (as defined in the legislation) for the sole purpose of applying for vehicle/asset finance

I hereby give consent

Date Accepted
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