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Address:
Salary Date:Net Income after deductions:FrequencyPlease selectMonthlyFortnightlyWeeklyIs the salary paid to bank?Please selectYesNo
Address:Province:Please selectEastern CapeFree StateGautengKwaZulu-NatalLimpopoMpumalangaNorthern CapeNorth WestWestern CapeCity---Suburb:---
Please do not include any expenses reflected on your pay slip. Please do not include any loans and/or credit accounts you may have with registered credit providers, banks, clothing accounts, etc. as part of your living expenses.
Total Monthly Living Expenses:
Are you currently under Debt Review, Debt Counselling or under Administration? Yes No
Is your spouse employed? Yes No
Name:Surname:Relationship:Please selectAuntBrotherBrother In LawCousinDaughterDaughter In LawFatherFather In LawGrandFatherGrandMotherMotherMother In LawNephewNieceSisterSister In LawSonSon In LawUncleContact No:Please select typeCellWorkHome
I declare the information on this form to be true and correct and hereby give consent to African Advantage to perform a credit check when assessing my application
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