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Credit Application in the name of: Where the application is in the name of a company , please enter all the releveant information such as Name of the Company, Trading Name and/or Trust name.
Surname Name
Marital Status Marital Status
Date of Birth
No. of Dependants
Licence No
Purpose of Loan
Trade Amt
Phone
Status Status
Phone
Contact name
Phone
Contact name
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Applicant 1 Monthly Income (After Tax) Other Income (Overtime/Rentals) *Details of other Income Monthly Income (After Tax)
Applicant 2
Monthly Expenditure Mortgage/Rent Board Other Mortgage payments Living Expenses Home Expenses (Utilites) Other Expenditure *Details of other Expenditure Mortgage/Rent Board Other Mortgage payments Living Expenses Home Expenses (Utilites) Other Expenditure
Monthly Expenditure
Personal Assets Cash In Bank Home Value Other Property Value Motor Vehicles Household Effects Business Assets Term deposits Other Assets *Details of other Assets Cash In Bank Home Value Other Property Value Motor Vehicles Household Effects Business Assets Term deposits Other Assets *Details of other Assets
Personal Assets
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Personal Liabilities Home Mortgage Other Property Mortgage Credit Card (Limit) Overdraft (Limit) Loans Outstanding Other Liabilities *Details of Other Liabilities Home Mortgage Other Property Mortgage Credit Card (Limit) Overdraft (Limit) Loans Outstanding Other Liabilities *Details of Other Liabilities
Personal Liabilities
REFERENCES
Accountant
Phone
Bank
Branch
Account Type
Reference- Mortgage/Landlord/Address
Phone
Personal References
Phone
Relationship
Phone
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FINANCE REFERENCES - complete for all applications Name of Financial Institution Branch Account No. Payments Taken Out
I/We are not undischarged bankrupt(s) and there are no unsatisfied judgements against me/us. I/We declare that the information given is true and correct. I/We authorise you to contact any person/company to obtain necessary data.
Applicant 1 Signature :
Applicant 2 Signature :
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