Contract number *
Date & Time *
Title *
Full Names *
Surname *
Cellphone number *
ID Number *
Email *
Home Address Line 1 *
Home Address Line 2 *
Suburb *
Postal Code *
City *
Home address Confirmed ? *
Loan Amount R *
Loan Term *
Total Loan Amount Repayment R *
Salary Pay day *
Account number where salary is paid *
Bank Name *
Account Type *
Basic Salary after deductions R *
Total Monthly Expenses (Rent/Grocery/Transport/Loans) *
Calculate total amount left after all deductions R *
Amount left qualify for loan R ? *

Working Sector 

 *
Confirm work address / Insert it *
Company or Department Name *
Workplace Phone Number(HR /Manager) *
Confirmed work number working ? *
Employment Status *
Employment Start Date *
Confirmed Employment Status ? *
Credit Status *
How many other loans you currently have? *
Total payment amount on your loans ? *
How did you hear about US ? *
Name and Surname of Referral
ID Copy *

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Latest Payslip *

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3 Months Bank Statements *

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