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Account
Lazarus
081 491 8313
Jeffery
084 736 2439
Office
011 918 0839
658 Trichardt Street, Beyers Park, Boksburg
Home
Showroom
About us
Sell Your Car
Finance Application
Contact us
Vehicle Finance Application
Vehicle Finance Application
Step
1
of
8
– Personal Information
12%
Salesman assisting you?
Vehicle Details
1. Personal Information
Title
(Required)
—
Mr.
Mrs.
Miss.
Dr.
Prof.
Sir.
First Name
(Required)
Middle Name
Surname
(Required)
ID / Passport Number
Date of birth
DD slash MM slash YYYY
Ethnic Group
—
Black
White
Indian
Colored
Oriental
Nationality
—
South African
Foreign National
Country if foreign national
—
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Are you a graduate
—
Yes
No
Marital Status
—
Married – ANC
Married – COP
Married – Customary Law / Tribal
Widowed
Divorced
Single
Date
DD slash MM slash YYYY
Email
Mobile Number
Land Line Number
Work Phone Number
2. Residential Address
Residential street address
Suburb
City
Province
—
Gauteng
North West
Limpopo
Mpumalanga
Free State
KwaZulu Natal
Eastern Cape
Northern Cape
Western Cape
Postal Code
Years at address
Occupation Type
—
Owner – Bond Free
Owner – Bonded
Tenant
Boader
Financial Institution – If Owner
3. Postal Address
Postal Address
City
Province
—
Gauteng
North West
Limpopo
Mpumalanga
Free State
KwaZulu Natal
Eastern Cape
Northern Cape
Western Cape
Postal Code
4. Employment Information
Company
Occupation
Employment Type
–
Full-Time
Part-Time
Temporary
Contract
Intern
Seasonal
Self Employed
Pensioner
Years at company
Employer Street Address
Suburb
City
Province
—
Gauteng
North West
Limpopo
Mpumalanga
Free State
KwaZulu Natal
Eastern Cape
Northern Cape
Western Cape
Postal Code
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. Income Information
Gross Income
Monthly Commission
Car Allowance
Overtime
Net Take-home Pay
Other Income
Totals
Total Monthly Income
Total Monthly Expenses
Date Remuneration is received
DD dash MM dash YYYY
8. Required Documents
ID Doc / Passport
Drop files here or
Select files
Accepted file types: jpg, png, pdf, jpeg, Max. file size: 10 MB.
Drivers Licence
Drop files here or
Select files
Accepted file types: jpg, png, pdf, jpeg, Max. file size: 10 MB.
Drivers Licence
Drop files here or
Select files
Accepted file types: jpg, png, pdf, jpeg, Max. file size: 10 MB.
Drivers Licence
Drop files here or
Select files
Accepted file types: jpg, png, pdf, jpeg, Max. file size: 10 MB.
Drivers Licence
Drop files here or
Select files
Accepted file types: jpg, png, pdf, jpeg, Max. file size: 10 MB.
9. Consent to credit provider
I am not a minor.
I have never been declared unfit by a court.
I am not subject to an administration order.
I do not have a current application pending for debt review restructuring or alleviation.
I do not have any current debt re-arrangement in existence.
I have not not previously applied for debt re-arrangement.
I am not under sequestration.
I do not have any applications pending for credit, nor open quotations as envisaged in section 92 of the national credit act.
I understand that I will be liable for a monthly service fee.
I hereby consent to this credit provider making enquires regarding my credit history any credit bureau.
I consent to this credit provider reporting the conclusion of any credit agreement with me to national loans register in compliance with this credit providers obligation under the national credit act.
I hereby declare that the information provided by me is true and correct.
Consent
(Required)
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.
Date Accepted
(Required)
DD slash MM slash YYYY
Comments
This field is for validation purposes and should be left unchanged.
WhatsApp us
Trade in
Vehicle Finance Application
1.
Car Information
Add your vehicle details
2.
Vehicle Condition
Add your vehicle details
3.
Contact details
Your contact details
Make
Model
Year
Transmission
Mileage
VIN
Upload your car Photos
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Provide a hosted video url of your car
Exterior color
Interior color
Owner
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What is the Exterior Condition?
Extra clean
Clean
Average
Below Average
I don't know
What is the Interior Condition?
Extra clean
Clean
Average
Below Average
I don't know
Has vehicle been in accident
Yes
No
I don't know
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First name*
Last name*
Email Address*
Phone number*
Comments
By submitting this form, you will be requesting trade-in value at no obligation and will be contacted within 48 hours by a sales representative.
Offer Price
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Trade price
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Schedule a Test Drive
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Request car price
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