Application Form


  1. The vehicle must be less than 15 years old.
  2. You must earn more than R6,500.00 per month after deductions.
  3. You must have a clear ITC record.
  4. You should be in possession of a valid RSA ID Book, none SA citizens with work permit also considered
  5. Must be in possession of a valid driver’s license.

Please remember that we can only give an accurate interest rate and private finance fees after we have done the full application & received all documents.

Please make sure you have the following available to upload before you start filling out the form:
  • Identity document
  • Drivers license
  • 3 months payslips
  • 3 months bank statements
  • Proof of residence (not older than 3 months)

You can also download our application form HERE


Vehicle & Purchase Price

Type of seats:
Balloon / Residual:

Personal Details

Marital status:      

Residential Details

Employer Details

Income Details

Do you deposit your other source of income:

Spouse Income Details

Does your Spouse deposit their other source of income:

Applicant Expenses Details

Spouse Expenses Details (if applicable)

Relative Details NOT Living with Applicant

Banking Details

I confirm that:

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 any current application pending for debt restructuring alleviation:


I do not have any current debt re-arrangement in existence:


I have not previously applied for a debt re-arrangement:


I am not under sequestration:


I do not have applications pending for credit, nor open quotations as envisaged in section 92 of National Credit Act:


If any of the above is incorrect, give details

Declaration by client

I hereby grant the Credit Provider the right to communicate with me through any electronic/written media or verbally in order to make available to me, their product offering and to utilise my information jfor supporting products as communicated by one of the Credit Provider(s) Partners:


I hereby grant the Credit Provider the right to increase my Credit Limit once every year to accommodate any Value Added Products needed and requested by me:


I authorise the Credit Provider to make enquiries about my credit record with any agency and to obtain whatever information on me they might require to process this application:


I also authorise the Credit Provider to share my payment behaviour with any credit agency:


Please email the documents listed below to

  • Identity document
  • Drivers license
  • Recent payslips 1
  • Recent payslips 2
  • Recent payslips 3
  • Proof of residence(not older than 3 months)
  • 3 months bank statements

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