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PLEASE SUBMIT YOUR DETAILS HERE.


Application approval subject to viewing of original documentation (This is not the actual application)
*Compulsory*
 

APPLICANT  
Title:
First Name:*
Surname:*
ID NO:*
Gender:
Tel Home:
Tel Work:
Tel Cell:*
Address:
Since:
Marital Status:
No of Dependants:
Residential Status:
Email Address:
Drives License:
   
EMPL0YMENT  
Occupation:
Employer's Name:
Employer's Address:
Date Employed:
   
INCOME  
Gross Income + Com:
Net Income:
BANK:
Type of Account:
Account Number:
Branch Code:
Date opened:
   
DEBT REPAYMENTS  
Home Loans:
Vehicle Loans:
Personal Loans:
Installment Loans:
Revolving/Credit Card:
   
LIVING EXPENSES  
Rates Water and Electricity:
Telephone and Cellphones:
Rent and Accommodation:
Education and School Fees:
Transport and Petrol:
Groceries, Food, Clothing:


 

SPOUSE  
First Name:
Surname:
ID NO:
Tel Home:
Tel Work:
Tel Cell:
Net Income:
   
ADDITIONAL CONTACT* DETAILS (Relative or Friend)
Title:
First Name:
Surname:
Relationship
Tel Work:
Employers Name:
Where did you hear about us?:*
What type of vehicle:*
Email Address:
 

If your application is successful within 3 days we will put you into good second-hand car. VELOCITY CARS have made it so easy for anyone to buy a car so that there's no need for you to use public transport anymore!!