Page 1 of 2
Quality Cars Application Form(Main)
FOR OFFICE USE
Vehicle
Year Model
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
contract
B
prepaid
Email
*
Drivers License
*
Drivers license type (South Africa or International)
License History-Had my License for
License History-Had my License for
A
0 - 5 years
B
5 - 10 years
C
10 - MORE
D
No License
Marital Status
*
Marital Status
A
Married
B
single
C
In Relationship
Spouse Details
Name and Surname
ID Number
R
esidential 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
Click to choose a file or drag here
Size limit: 10 MB
Id
*
Click to choose a file or drag here
Size limit: 10 MB
Drivers Licence
Click to choose a file or drag here
Size limit: 10 MB
Payslips
*
Click to choose a file or drag here
Size limit: 10 MB
Bank Statements
Click to choose a file or drag here
Size limit: 10 MB
Signature
*
Signature
Submit
