Application

PLEASE COMPLETE THIS APPLICATION FORM

EMPLOYER DETAILS

BANK DETAILS

I hereby agree that the information above is true and correct *

DRIVING DETAILS

LANGUAGE PREFERENCE

BOND DETAILS

SELECT:

HOUSEHOLD & EXPENSES PER MONTH

DECLARATION BY CLIENT

I CONFIRM THAT: *
I hereby grant the Owner or Agent of EZ Prestige the right to communicate with me through any electronic / written media or verbally to make available to me, their product offering and to utilize my information for supporting products as communicated by one of the Credit Provider’s Partner. *
I hereby grant the Owner or Agent of EZ Prestige the right to increase my credit limit once every year to accommodate any value-added product needed and requested by me. *
I hereby declare that all information provided above is true and correct *
A. I am not a minor
B. I have never been declared mentally unfit by court
C. I am not subject to an administration order
D. I do not have any other current application pending for debt restructuring or alleviation
E. I do not have any 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
I. The following consent information is correct: I hereby consent to the Credit Provider accessing my credit profile from the credit bureaus for the purposes of a credit assessment and in the event that my loan application is successful, for on-going account maintenance purposes, setting limits, development of credit tools/products/models and insurance purposes

PERMISSION TO MARKET

Do you consent to your information being shared in order to receive marketing regarding insurance and related products?