Rent-to-Buy · Application Form

Apply for Rent-to-Buy

Complete the form below. Our team reviews every application personally — if you qualify, we'll be in touch within 24–72 hours.

Vehicle & Deal Details

Goods Description: Make & Model

Deposit

Total Monthly RentalPeriod: 54 months

Your Contact Number

Where did you hear about us? Please specify.

Personal Details

Title

Surname

ID Number

Full Names

Initials

Number of Dependants

Gender

MaleFemale

Marital Status

MarriedANCCOPSingleWidowed

Date Married

Home Address

Period at Address

Suburb

Province

Cell

Work Direct

Postal Address

Postal Code

Previous Address

Period at Previous Address

Spouse & Next of Kin

Spouse Names

Spouse ID Number

Spouse Contact

Spouse Cell

Spouse Work

Next of Kin (not spouse & not living with you)

Full Name

Relationship

Address

Telephone

Property Details

Bond Holder?

YesNo

Monthly Bond Repayment

Renting Property?

YesNo

Monthly Rental Amount

Employment Details

Employer

Occupation

Employer Address

No. of Years with Employer

HR Details: Name

HR Number

Salary Date

Previous Employer

No. of Years (Previous Employer)

Spouse Employer

Spouse No. of Years

Spouse Occupation

Bank Details

Bank Name

Branch Name

Branch Code

Name of Account Holder

Account Number

Account Type

SavingsTransmissionCurrent

Income

Salary Details

Own

Spouse

Basic Monthly (excl. car allowance)

Car Allowance

Total Salary (Basic & Car Allowance)

Monthly Commission

Net Take Home Pay

Income Other Than Salary / Wages

Source of Other Income

Total Monthly Household Income (Net Salary & Other)

I hereby give consent to the company to make enquiries about my personal & financial records with any agency and to obtain whatever information on me they might require to process the application. I hereby declare that all the above information and supporting documents are true and correct.

I agree to the above declaration and give my consent.

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