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Loan Application Form

Loan Application form

PERSONAL DETAILS

CONTACT DETAILS

EMPLOYMENT DETAILS

LOAN DETAILS

COLLATERAL DETAILS

BANK DETAILS

SUPPORTING DOCUMENTATION

LEGAL TERMS

PERSONAL DETAILS

Name

First

Last

ID Number

Date of Birth

Gender

Race

Do you receive a Social grant?

Ever Declared insolvent?

CONTACT DETAILS

Residential Address

Postal code

Suburb

City

Province

Telephone number (Home)

Telephone number (Work)

Cellphone number

Email address*

EMPLOYMENT DETAILS

Employment status

Occupation

Employee number

Fund membership number

Union number

LOAN DETAILS

Loan Plan

Loan Amount (ZAR)

Purpose of loan

COLLATERAL DETAILS

Employer-guaranteed Loan Payment Authorization

I accept to repay my loan from my wages / salary

I authorize my employer to repay my loan from my wages / salary

Company Name

Company Address

Company Telephone

Company Website

COMPANY APPROVAL'S DETAILS

HR MANAGER'S NAME

Prefix

First

Last

HR PHONE

Email address*

Net Salary: As per payslip (ZAR)

Gross Salary: As per payslip (ZAR)

BANK DETAILS

BENEFICIARY DETAILS (Account loan to be paid into)

I accept to receive my loan payment on the bank details registered on my profile

SUPPORTING DOCUMENTATION

BENEFICIARY DETAILS (Account loan to be paid into)

Latest Payslip

Valid acceptable Identity Document (eg certified copy of green bar-coded Identity Document)

Valid, acceptable verification document confirming residential address (eg utility bill not older than 3 months)

LEGAL TERMS

I acknowledge that the information supplied by me shall constitute the basis on which my application is to be considered and that all such information is of material importance and directly relevant to the consideration of my application.

I warrant that all information I supplied is to the best of my knowledge and belief true and correct in all material respects and I am not aware of any other information which, should it become known to you, would affect the consideration of my application in any way.

I consent to the Asonge Sonke, my fund and/or its fund administrator as well as my employer sharing any of my personal and financial information among them as may be required to proceed and implement this loan that I have applied for.

I declare and warrant that:
1. I am not under debt counselling or subject to debt review;
2. I have disclosed to you all other applications for credit that I have made to other credit providers, whether they have been processed or not at the date of this application;
3. entering into this agreement will not cause me to become over-indebted as set out in the National Credit Act.

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