Personal & Pay Day Loan Application

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Pre Qualifying Questions- Step 1 of 3
Are you under Administration? *	Yes No
Are you under Debt Review ? *	Yes No
Salary Frequency *	Monthly Weekly Forth Nightly
Personal Details
Title *
Name *
Surname *
Id Number *
Cell Number *
Work Number *
Home Number
Email *
Altenate Email
Home Address *
Postal Address *
Marriage Status *
Bank Details
Bank Name *
Account Number *
Type *	Savings Cheque
Branch code *

Loan Details- Step 2 of 3
Loan Amount *	R500 R1000 R1500 R2000 R2500 R3000 R4000 R5000 R6000 R7000 R8000 R9000 R10000 R11000 R12000 R13000 R14000 R15000 R16000 R17000 R18000 R19000 R20000
Will you accept a loan lower than R1000 *	Yes No
Employment Details
Employer Name *
Job Title *
Date you started *
Employee Number *
Employment Status *
Pay date	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Period of Employment *
Gross Salary(as per payslip) *
Nett Salary(As per pay slip) *
Total amount of debit orders(as per bank statement) *
Expenses *
Hr officer name *
Hr number *
Company address *
Postal code

Next of kin Details- Step 3 of 3
Next of kin name *
Next of Kin Cell Number *
Next of kin address *
By clicking submit, you agree too your email and personal information to be stored for marketing purpose. By submitting the above details you give permission to submit your details to the credit bureau. Note: Credit facility approval is subject to standard affordability and National Credit Act requirements as well the credit granting criteria of our partners.From time too time there may be delays in the loan process.We cannot be held responsible for delays in the loan process by any service providers.