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Quality Cars Application Form(Main)

FOR OFFICE USE

Vehicle

Selling Price

M&M Code

PERSONAL INFORMATION

FINANCE OPTION (Please select)

(IF Blacklisted , Rental DEPOSIT STARTS FROM R20 000) How much deposit from do you have ?

Title

First Name

Last Name

ID

NATIONALITY

Phone Number

Is this Nr contract or prepaid

Is this Nr contract or prepaid
A
B

Email

Drivers License

Drivers license type (South Africa or International)

License History-Had my License for

License History-Had my License for
A
B
C
D

Marital Status

Marital Status
A
B
C

Spouse Details

Name and Surname

ID Number

Residential Details

Street Address

Area

City

HOW MANY YEARS /MONTHS

Owner or Tenant

PREVIOUS Address (Important for Rental purposes, Can make difference on Deposit and Installment)

Street Address

Area

City

HOW MANY YEARS / MONTHS

Next of Kin (Friend or family Not living with you)

Name and surname

Address

Contact nr

Employer's Name:

Employer Details

Address

Work telephone Number

Occupation

Currently employed for How many Years and Months

Basic Salary (Before deductions)

Additional income

Amount

Commission

Nett home take salary

Self employed please state what is  your business

Previous Employer's Name: (rental requirement)

Company name

Occupation at previous Employer

Previous Employer's details: (rental requirement)

Address

How long did you work at previous employer

Bank Details

Bank name

Account Number

Home Bond / Rent per month

Vehicle Loan

Personal Loan

Revolving/Credit Card

Clothing Or Furniture Account:

Electricity

Cellphones

Transport and Petrol

Groceries, Food, :

Are you Blacklisted/ debt review/ skipped payment/ arranged payments

IF Blacklisted/ debt review/ skipped payment/ arranged payments please Clarify

By replying to this email I give Quality Cars and Finance brokers Authorisation to forward my personal details to all Finance / Insurance Companies.

Signature

CLEAR SCORE

Id

Drivers Licence

Payslips

Bank Statements

Signature

Signature