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Confirmation

I CONFIRM THAT

a) I am not a Minor
b) I have never been declared unfit by a court
c) I am not subject to an administration order
d) I do not have any current application pending for debt restructuring or alleviation
e) I do not have any current debt re-arrangement in existence
f) I have not previously applied for a debt re-arrangement
g) I am not under sequestration
h) 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 are incorrect please provide details:

PAYMENT HISTORY

Are you currently under debt-review?
Do you have a rearrangement in place with any credit?
Are you currently under Administration order of Curator Bonis?
Provider as a result of debt counselling?
Have you ever had a judgement against you to your knowledge?
Have you ever been under administration order?
Are you currently under sequestration order?
Do you have a dispute in progress with a credit bureau?

 

DECLARATION BY CLIENT

I hereby grant the Credit Provider the right to communicate with me through any electronic / written media or verbally in order to make available to me, their products offering and to utilize my information for supporting products as communicated by one of the Credit Provider's Partners.
I hereby grant the Credit Provider the right to increase my Credit Limit once every year to accommodate any Value Added Products needed and requested by me.
I authorise the Credit Provider to make enquires about my credit record with any credit agency and to obtain whatever information on me, they might require to process this application.
I also authorize the Credit Provider to share my payment behaviour with any credit agency.

 

I CONFIRM ALL OF THE ABOVEMENTIONED TO BE TRUTHFULL AND CORRECT AND HAS BEEN COMPLETED BY MYSELF

*as soon as approval has been received AFS will fax form to be signed and verified

This application is submitted electronically. Please fax your ID, drivers licence, your latest pay slip, the last 3 months bank statements and the latest proof of physical address to: 086 219 6989

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