Application Form for Taxi Finance

VELA TAXI FINANCE

APPLICATION FORM FOR TAXI FINANCE

Personal Details
Title / Gender / M / F
Surname / First Name
ID Number / Other Names
Language / Race / B / C / I / W
Cell Number / Work Number
Home Number / Email Address
Business Details
Business Name / Self Employed / Y / N
Years in Operation
Tax Number / VAT Number
No of Routes / No of Taxis
Route 1 / Route 2
OL Number / OL Number
Start / Start
Finish / Finish
Distance / Distance
Route 3 / Route 4
OL Number / OL Number
Start / Start
Finish / Finish
Distance / Distance
Residential Details
Home Address / Postal Address
Postal Code / Postal Code
Do you own the property / Y / N / Period at this address
Rental / Period at previous address
Marriage Details
Status / M / S / W / D / Marriage Contract / ANC / COP / Trad
Spouses Name / Date of Marriage
Spouse Tel Number / Spouses Income
Next of Kin
Name / Tel Number
Relationship
Relative Details
Relatives Name / Relative Tel Number
Relationship
Banking Details
Name of Bank / Account Name
Branch Name / Account Number
Branch Code / Account Type
Income and Expenditure
Monthly Income
Commissions
Other Income
Total Income
Rent/Bond
Rates, Water, Electricity
Current Loan Repayments
Insurance Premiums
Telephone/Cellphone Account
Food & Entertainment
Education Costs
Maintenance
Groceries
Other
Total Expenses
Surplus/Deficit
Vehicle Details
Make / Model
M&M Code / Purchase Price

Declarations

Are you a minor?Yes/No

Have you ever been declared mentally unfit by a court?Yes/No

Are you subject to an administration order?Yes/No

Do you have any current application pending for debt restructuring or alleviation?Yes/No

Do you have any current debt re-arrangement in existenceYes/No

Have you previously applied for a debt re-arrangement.Yes/No

Are you under sequestration.Yes/No

Do you have applications pending for credit, or open quotations as envisaged in section 92 of the National Credit Act? Yes/No

You understand that I will be liable for a monthly service fee.Yes/No

You hereby consent to this Credit Provider making enquiries regarding my credit history with any credit bureau.
You consent to this Credit Provider reporting the conclusion of any credit agreement with me to the National Loans Register in compliance with this Credit Provider’s obligation under the National Credit Act.
You hereby declare that the information provided by me is true and correct.

Applicants Name:______

Applicants Signature:______

Date:______