Finance Form

Finance you're golf simulator today!

Please fill out the form with the total amount that needs to be financed.

All finance applications is subject to affordability and risk assessment.

Play now Pay later

Complete form now or download pdf here.

Applicants Details

Title:

Initials:

First Name

Last Name

Gender:

Male

Female

Graduate:

Yes

ID Number:

Email:

Number (Work):

Number: (Home)

Number (Cell):

Address

Period at this property:

Employer Name (Please state if self employed):

Employer Telephone Number:

Employer Email Address:

Type of Industry:

Occupation:

Employee Number:

Period at Employer:

Do you own the Property:

Property Bond (In who's name)::

Property Type:

Property Structure:

Spouse Details (if COP)

Spouse Surname:

Spouse Name:

Spouse Email Address:

Spouse Address:

Spouse Phone Number:

Spouse Gross Monthly Income:

Spouse ID Number / Date of Birth:

Spouse Employer Name:

Spouse Employer Address:

Applicants Bank Details

Applicant's Bank Name:

Applicant's Account Holder Name:

Applicant's Account Number:

Applicant's Branch Name:

Are you currently liable as:

Applicants Income Details

Gross Monthly Income:

Total Monthly Expenses:

Applicant's Total Desposible Income:

Bond Payment/Repayment Amount:

Rates, Water, Electricity

Policy, Insurance Payments:

Vehicle Instalments:

Personal Loan Payments:

Credit Card Repayments:

Furniture Accounts:

Clothing Accounts:

Overdraft Payments:

Medical Aid:

Investments:

Pension:

Contract Tel, Cell, Internet

Transport Cost:

Food & Entertainment:

Educational Costs:

Maintenance:

Household Expenses:

UIF:

Total Tax:

Other:

Assets

Fixed Property Value:

Motor Vehicles:

Furniture :

Electronic Equipment:

Jewellery and Valuables:

Cash & Other Deposits:

Other:

Total Assets:

Liabilities:

Fixed Property:

Motor Vehicle:

Furniture:

Electronic Equipment:

Jewellery and Valuables:

Cash & Other Deposits:

Other:

Total Liabilities:

Asset Details:

Total Financed Amount:

Deposit Amount:

Preferred Debit Order Date:

Pre-Screening Questions

I confirm that:

I am not a minor

I have never been declared mentally unfit by the court

I am not subject to an administration order

I do not have any current applications pending for debt restructuring or alleviation

I do not have any current debt re-arrangement in existance

I have not previously applied for a debt re-arrangement

I am not under sequestration

I do not have applications pending for credit, nor open quotations as envisaged in section 92 of the National Credit Act

If any of the above is incorrect, state which and give details:

Marketing Consent

I consent to you sharing my personal information within the group for marketing purposes and the group then marketing it's products, services and special offers to me.

Yes

Credit Consent

I understand that I will be liable for a monthly service fee. I Consent to this service provider reporting the conclusion of ay credit agreement with me to the National Loans Register in compliance with this Credit Provider's obligation under the National Credit Act. I herby declare that the information provided by me is true and correct. I consent to the bank making enquiries about my credit record with credit reference agencies and credit bureau for the purpose of assessing the credit application or updating myinformation in future. I also consent to the bank sharing information with such agencies about how I manage this loan agreement, who may in turn share this information with other credit providers. I consent to identity and fruad prvention checks and sharing information relating to this application through the South African Fraud Prevention Service.

Yes

Consent to the Merchant West Group

I consent to the Merchant West Group, processing the required personal information, as provided above and acknowledged that I understand the purposes of which it is required and for which it will be used.

I ,the undersigned, hereby declare that the information provided herein is both true and correct, in every aspect and represents a true reflection of my personal financial position.

CONSENT TO PROCESS PERSONAL INFORMATION IN TERMS OF THE PROTECTION OF PERSONAL INFORMATION ACT NO. 4 OF 2013 (POPI)

In terms of POPI, Merchant West Group is required to process your I your company's Personal Information in a lawful and reasonable manner. INFORMATION REQUIRED: Merchant West Group requires the following personal information:

Registration documentation in respect of the company I close corporation I trust (in the event of a trust (or shareholding constituting of a trust), a copy of the trust deed and list of beneficiaries and clear certified copies of their identity documents); certified copies of identity documents of directors I members I trustees I partnerships I individual; credit applications; latest audited financial statements; latest 3 (three) months' bank statements; interim management statements; company letterhead; utility bill for all guarantors; trade references; 3 (three) months' telephone account; resolution I power of attorney; confirmation of banking details (confirmation on bank letterhead); landlord waiver; insurance confirmation; settlement disclosures; ITC checks and reports (to request and to disclose information to third parties).

PURPOSE OF COLLECTION

MANDATORY

Processing of finance applications (internally and externally); drafting and finalizing rental/instalment sale/transaction/facility agreements; to evaluate risk assessments in accordance with relevant and applicable legislation and regulation; comply with all tax and financial obligation; processing for invoice purposes; perform necessary background verification; communication; formalize client contractual arrangements which include uploading, storage and maintaining information on our database.

INFORMATION TO INDEPENDENT FINANCE AGENT

Merchant West Group will subject all Credit Applications received, for verification by an independent third party, which include all approved finance houses for Merchant West Group and/or internal verification methods, of which the costs will be for Merchant West Group and/or the approved finance houses. The appointed third party will adhere to all necessary requirements in respect of POPI.

I accept terms & conditions

Full Name:

Your Signature

Applicants ID:

Upload File

3 Month's Salary Slips (6 Month's if on Commision)

Upload File

3 Month's Bank Statements (6 Month's if on Commision)

Upload File

Screen Shot of Shopping Cart Total:

Upload File

Proof of Address (in youre name)

Upload File

Finance Form

Complete form now or download pdf here.

Applicants Details

Spouse Details (if COP)

Applicants Bank Details

Applicants Income Details

Assets

Liabilities:

Asset Details:

Pre-Screening Questions

Marketing Consent

Credit Consent

Consent to the Merchant West Group

Thanks for submitting!