Online Finance Application - EBK Auto Dealers

Disclaimer -This form is 100% safe. It will request personal information about you. Please contact EBK Autodealers directly if you are uncomfortable giving any of this information. Please accept this disclaimer to continue.

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Personal Information

Vehicle of Interest

Sales Person

Title

First

Last

Gender

ID Number

Phone

Email

Address

Street Address

Address Line 2

City

State / Province

ZIP / Postal Code

Country

How long have you been staying here?

Property Details

Previous Address

Street Address

Address Line 2

City

State / Province

ZIP / Postal Code

Country

Marital status

Spouse Information

Spouse First Name

Spouse Last Name

Spouse ID

Date Married

Dependents

Next of Kin First Name

Next of Kin Last Name

Relationship to you

Their Contact number

Next of Kin Address

Street Address

Address Line 2

City

State / Province

ZIP / Postal Code

Country

Employment Information

Company Name

Position

Company Address

Street Address

Address Line 2

City

State / Province

ZIP / Postal Code

Country

Company Number

How long have you been there

Salary Date

Income & Expenses

Salary before Deductions

Salary After Deductions

Other income

Source of other income

Bond / Rent

Vehicle (if not settling)

Rates / Water / Electricity

Personal Loans

Credit Cards

Clothing Accounts

Cell Phone / Internet

Food & Entertainment

Banking Details

Disclaimer

I grant EBK Autodealers permission to submit my application for the above vehicle and all related value added products on my behalf.

ID Copy

File Upload

Drivers License

File Upload

Payslips

File Upload

Proof of Address

File Upload

3 Months Bank Statement

File Upload

I confirm that:

√ I am not a minor.
√ I have never been declared mentally unfit by a court.
√ I am not subject to an administration/ garnishee order.
√ I do not have any current application pending for debt restructuring or alleviation.
√ I do not have any current debt re-arrangement in existence.
√ I have not applied for debt re-arrangement.
√ I am not under sequestration.
√ I do not have applications pending for credit, nor open quotations as envisaged in section 29 of the National Credit Act.
√ I hereby grant the Credit Provider the right to communicate with me through any electronic/ written media or verbally in order to make available to me, their product offering.

I hereby give consent to the Credit Provider to make enquiries about my credit record with any credit agency and to obtain whatever information on me they might require to process the application. I also give consent to the Credit Provider to share my payment behaviour with any credit agency. I hereby grant the credit provider consent to request and access my private personal information, including but not limited to ID, driver’s license, bank statements, payslips, proof of address and other information required for this application for vehicle finance. I hereby grant the Credit Provider the right to increase my Credit Limit once every year to accommodate any Value Added Products needed and requested by me. I hereby declare that all of the above information is true and correct.