BMW Financial Services Client No Application Number
Finance Application
Application Date ID Number
Individual Applicant
Sole Proprietor
Use Block Letters Instalment Lease Sale
Surety/Co-Debtor
Year of Reg
New
For used cars only
AUC
Yes
Goods Description
Kilometres
km
M&M Code
Motor plan up to
km
Cash Price
Motorplan
Delivery fee
Accessories
Initial Fuelling Charges Balloon payment / Residual
License and Registration Costs
A. Vehicle
Dealer Tel No Sales Person
Other
Fax/Email
Extras Description
Special Requirements Business
Private
Total of Extras
Debit Order Date
Dealer VAPS Description
Proposed Rate
Dealer VAPS Total
Period
Source of Deposit
Initiation Fees to be financed?
No
Yes
Date of Birth
Less Deposit/ /Initial Rental
Total Gender
M
F
Graduate?
Surname
Title:
B. Personal
Credit Life/TopUp
Contact No
Purpose of goods
C.Contacts
No
Surety ID (if appl.)
Used
No
Dealer
Ethnic Group
A
B
C
W
Undisclosed
Marital Status
Single
Married
Divorced
Separated*
Widowed
Contract
COP*
ANC
Y
Date Married
Outside SA*
Tribal Law*
Nationality
South African
Spouse ID
Verification of marital status: Client Signature
*Spouse's consent Other
Country of Residence
Permit Type
Permit No
Permit Exp Date
Trading as/ Name
Tax no
Vat No
Cell No
Home No (
Contract Information
Email:
Y
N
Contract Documentation (e.g. Statements)
Email:
Y
N
)
Fax No SMS: Y
N
Email Address Previous Address
Code Yrs
Period at Address
) N
Normal Post: Y
N
Code Mths
Period at Address
Bimonthly
Postal Address
Suburb Yrs
Type of House
House
Flat
Townhouse
Farm
Residential Status
Owner
Renter
Living with family
Other
Registered Owner
Self
Spouse
Both
Other
Bonded
Bond-free
Code
Mths Plot Next of Kin Not living with you Address In SA
Caravan/ Mobile home
Boarding house/ Hostel/Hotel
Leased
Year Purchased
Current Value
Purchase Price
Balance Owing
Rent / Bond Payment
Erf Number
Bondholder Name
(
Normal Post: Y
Statement Frequency: Quarterly
Suburb
Home Status
N
Spouse name No. of Depend.
Names
Present Address
D. Residential
Do you require information on insurance ? Yes
Tick Appropriate Boxes Mobility Other Plan
Code Phone No
(
)
Relationship If a flexi/access bond, total facility granted?
Initial
BMW Financial Services (South Africa) (Pty) Ltd is a Registered Credit Provider and an Authorised Financial Services Provider.
Client No Application Number
Finance Application
Application Date ID Number
E. Employment
Individual Applicant
Sole Proprietor
Surety/Co-Debtor
Present Employer
Previous Employer
Spouse Employer
Address
Address
Address Code
Time with Employer
Code Time with Employer Phone
(
Yrs
Code
Yrs
Mths
Occupation
Mths
)
Employed
Bank (for Debit Order)
Time with Employer
F. Banking
Mths
Industry Full-time
Part-time
Self-employed
Account Type
Retired
Unemployed
Account Number
Branch Name
Branch Code
Account Holder Name
(if appl) Overdraft Bal:
Limit
Nr of Credit Card(s)
Cr. Facility Bal: Straight
Budget
Cr. Facility Limit: Straight
Budget
Finance Account Number (1)
To Settle
Yes
No
Finance Account Number (2)
To Settle
Yes
No
Other Bank
To Settle
Yes
No
Account Type
Bank
G. Income
Yrs
Present Balance
Account Number
Branch Name
Branch Code
Number of Long Term Loans (Personal loan, Vehicle, Bond etc...)
Long Term Loans Balance
Income per month:
Household Expenses per month:
Gross Remuneration
Bond Payment/Rent
Rates, Water and Electricity
Monthly Commission (3 month avg)
Vehicle Instalments (excluding those to be settled)
Personal Loan Repayments
Car Allowance included in Gross
Credit Card Repayments
Furniture Accounts
Net Take-home Pay
Clothing Accounts
Overdraft Repayments
Income other than Salary/Wages
Policy/Insurance Repayments
Telephone Payment
Source of income
Transport Costs
Food and Entertainment
Education Costs
Maintenance
Household Expenses
Other
Total Monthly Income
Total Monthly Expenses
Applicant's Disposible Income Spouse Salary
Day Remuneration Received Are you currently liable as
Surety
Guarantor
Co-debtor
Specify Details
I confirm that: A. I am not a minor. B. I have never been declared mentally unfit by a court. C. I am not subject to an Administration Order. D. I do not have any current application/s 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 is incorrect, state which and give details: ___________________________________________________________________________________________________________________ We will not disclose any personal information to any unauthorised party outside of the BMW Group Companies. In order to provide outstanding service to you, we would like your consent to share your details within the BMW Group Companies and dealerships. Do you give your consent? In order for us to improve our service to you, would you like to be included in BMW Group Company surveys and telemarketing? BMW Group Companies and dealerships may offer exclusive deals to our customers. Would you like to be included in these offers? BMW Financial Services consistently reviews our product offerings to ensure that we are able to fulfill your financing needs. Would you like to be informed about new products?
Y Y Y Y
I understand that I will be liable for a monthly service fee. I hereby consent to the relevant Credit Provider making enquiries regarding my credit history with any credit bureau. I consent to the relevant Credit Provider reporting the conclusion of any credit agreement with me to the National Loans Register in compliance with the relevant Credit Provider's obligation under the National Credit Act. I hereby declare that the information provided by me is true and correct. Signature of Applicant ___________________________________________________
Date ______________________________
I, ________________________________________an accredited Finance and Insurance Manager acting as an agent on behalf of BMW Financial Services, confirm that the applicant has telephonically confirmed the information to be true and correct, and that permission has been obtained telephonically from the applicant to perform the necessary credit bureaus checks. Signature ___________________________________________________
Date ______________________________
N N N N