CREDIT APPLICATION This application is subject to credit approval DESCRIPTION OF GOODS:
RENTAL AMOUNT (excl. VAT) AS PER QUOTE
SUPPLIER
SETTLEMENT PAYABLE?/TO WHOM?
INCREDIBLE CONNECTION Purpose of Purchase: Replacement:
PERIOD
Upgrading:
Expansion:
PLEASE NOTE: THERE IS A ONCE-OFF DOCUMENTATION FEE CHARGED ON EVERY TRANSACTION (THIS AMOUNT WILL BE ON THE APPROVAL LETTER)
NAME OF COMPANY : Close Corporation
Propperty
(Pty) Ltd
Limited
Sole Proprietor
Partnership
Owned:
Contact:
Street Address :
Reg No :
Postal Address :
Years Trading:
E-Mail Address:
VAT No:
Web Site:
Tel No :
Nature of Business : Source of Income (Mandatory): Public Administration
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Full Names
Membership Fees
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Investments Trade Income-Sales
I.D. Number
Financial Services
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Trade Income-Services
Rental Income
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Trade Finance
Financials Available: Commission
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DIRECTORS / MEMBERS / SHAREHOLDERS / OWNERS DETAILS Residential Address Value % Shares
Auditors Name:
Tel No :
Insurer's Name:
Tel No :
Landlord's Name:
Tel No :
Bankers:
Acc No:
Branch:
Period with bank:
Name
TRADE REFERENCES Tel No.
Yes/No:
Bond O/S
Tel No.
ANNUAL TURNOVER Account No/Contact NET ASSET VALUE
IN ADDITION TO THIS FORM, PLEASE SUPPLY US WITH THE FOLLOWING DOCUMENTS IN ORDER TO PROCESS YOUR APPLICATION : Completed and Signed Moratorium Questionnaire Latest 3 Month’s bank statements Latest Signed Audited Financial Statements If Financials are older than 6 months, up to date Management Accounts Company Registration/Founding Documents; Clear ID copies of all directors/ members A copy of cancelled cheque or bank letter confirming banking details Supplier Quote
Trade Reference & Credit Bureau Consent I/We hereby consent to you or your cessionary/ies making enquiries to my/our credit records and trade references with any credit reference agency or any third party to confirm the details provided and confirm that this consent shall apply in every respect to every director, shareholder, member and/or associate of the applicant. As a signatory to this application I/we hereby indemnify you or your cessionary/ies against any claim that may be made against you or your cessionary/ies by any director, shareholder, member and/or associate of the applicant by virtue of this consent. Marketing Consent I/We consent to Finance Africa providing personal details to its cessionary/ies, subsidiaries and associated entities and other departments for purposes of marketing and referring potential business opportunities from and by its cessionary/ies, subsidiaries and associated entities as well as for credit assessment purposes. Financial Intelligence Centre Acts (FICA) All accountable institutions are required to identify their clients as required by the Financial Intelligence Centre Act No 38 of 2001. We therefore consent to you carrying out identity and fraud prevention checks and sharing information as required.
Trade Reference & Credit Bureau Consent I/We hereby consent to you or your cessionary/ies making enquiries to my/our credit records and trade references with any credit reference agency or any third party to confirm the details provided and confirm that this consent shall apply in every respect to every director, shareholder, member and/or associate of the applicant. As a signatory to this application I/we hereby indemnify you or your cessionary/ies against any claim that may be made against you or your cessionary/ies by any director, shareholder, member and/or associate of the applicant by virtue of this consent. Marketing Consent I/We consent to Finance Africa providing personal details to its cessionary/ies, subsidiaries and associated entities and other departments for purposes of marketing and referring potential business opportunities from and by its cessionary/ies, subsidiaries and associated entities as well as for credit assessment purposes. Financial Intelligence Centre Acts (FICA) All accountable institutions are required to identify their clients as required by the Financial Intelligence Centre Act No 38 of 2001. We therefore consent to you carrying out identity and fraud prevention checks and sharing information as required. Certificate I/We certify that to the best of my/our knowledge and belief the information I/we have given you is correct and I/we are not aware of any matters of circumstances which I/we have not disclosed to you in writing which might influence your decision. I/We certify that there are no writs, summonses, judgements, petitions, winding up order or pending applications for liquidation or threatened against the Applicant or its directors/shareholders. Annual Turnover I/We warrant that the Annual Turnover and/or Net Asset Value is true and correct and acknowledge that Finance Africa has relied on warranty in determining the legal framework of the facility.
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Consent to Process Personal Information In terms of the Protection of Personal Information Act 4 of 2013 (“POPIA”), Ezemali Afrika (Pty) Ltd t/a Finance Africa is obliged to obtain the consent of the person or entity set out above (“the Applicant”) to process all personal information of Applicant as defined within POPIA (“the Personal Information”). Therefore, the Applicant expressly consents and agrees that Finance Africa may: - make enquiries of whatever nature with any third party including without limiting; credit bureaus to confirm and verify any Personal Information received from the Applicant; - collect and process the Personal Information for purposes of providing the services provided in terms of a rental agreement entered into directly with the Applicant or which may be entered into by the Applicant with a supplier and which agreement was subsequently ceded to Finance Africa and to administer and maintain the business relationship with the Applicant; - process and disclose the Personal Information for the following purposes: * the prevention, detection and reporting of fraud and criminal activities including money laundering activities; * in compliance with any legal obligation; * to any person providing services to or requiring services from or representative, agent or supplier of Finance Africa * to any entity or person that may cede or assign to Finance Africa an agreement with the Applicant; * determining the creditworthiness of the Applicant and retain and utilise the Personal Information for credit record and scoring purposes; * marketing to and business opportunities with related entities of Finance Africa;
Customer Signature: Customer Full Name: For and on behalf of:
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Date: Capacity: