53 Motor Group | Finance

Are You Blacklisted Or Under Debt Review?*

Do You Have The Following?*

Valid SA ID

Valid Driver's License

Both Fields Need To Be Ticked

Race/Ethnic Group*

Asian
Coloured
Black
White
Other

First Name*

Last Name

You ID Number*

This Field is Required

Your Phone Number*

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Your Work Number*

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Your Email Address*

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Street Address*

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Address Line 2

City*

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ZIP/Postal Code*

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State/Province*

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Country*

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How Long Have You Stayed At This Address*

This Field Is Required

Type Of Residency*

Tenant
Bond
Lodger
Living With Partner/Friend/Family

MARITAL STATUS

Marital Status *

Single
Divorced
Living Together
Married COP
Married ANC
Traditional Marriage

First Name*

Last Name

Spouse ID * Spouse Telephone Number *

Wedding Date

Day

Month

January
Febuary
March
April
May
June
July
August
September
October
November
December

Year

Employment Details

Employment Type

Unemployed
Self Employed
Farmer
Temporary Worker
Permanent
Student

Employer Name*

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Job Title *

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Work Address*

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Employment Length(Years)*

Income Details

GROSS ALL COMMISSION & OVERTIME INCLUDED *

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NETTO SALARY INCLUDING COMMISSION & OVERTIME *

This Field Is Required

SOURCE OF EXTRA INCOME *

This Field Is Required

Applicant Expense

Bond Or Rent *

This Field Is Required

Water & Electricity *

This Field Is Required

Personal Loan Installment/s *

This Field Is Required

Furniture Account *

This Field Is Required

Clothing Account *

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Policies And Insurance *

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Telephone Costs *

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Food & Entertainment *

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Educational Costs *

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Maintenance To Ex Spouse *

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Household Expenses *

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Next Of Kin

First Name*

Last Name

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Relationship To You *

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Next Of Kin Telephone Number *

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Banking Details

Where Do You Bank

ABSA
FNB
Standard Bank
CAPITEC
Nedbank
Investec

Acount Type

Cheque
Savings
Transmissions
Other

Account Number*

This Field Is Required

POPI Disclaimer

WE RESPECT YOUR RIGHT TO PRIVACY AND THEREFORE AIM TO ENSURE THAT WE COMPLY WITH THE LEGAL REQUIREMENT OF THE POPI ACT WHICH REGULATES THE MANNER IN WHICH WE COLLECT, PROCESS, STORE, SHARE AND DESTROY ANY PERSONAL INFORMATION WHICH YOU HAVE PROVIDED TO US.

Your Rights

RECTIFY THE PERSONAL INFORMATION COLLECTED BY US
OBJECT TO THE PROCESSING OF INFORMATION(SUBJECT TO LEGISLATION)
REQUEST THE RETURN OR DESTRUCTION OF PERSONAL INFORMATION (SUBJECT TO LEGISLATION)
LODGE A COMPLAINT WITH THE COMPANY
THE PERSONAL INFORMATION PROCESSED BY US IS NOT ROUTED/TRANSFERRED TO A THIRD COUNTY OR INTERNATIONAL ORGANIZATION