Application Form

Personal Details

Title

Surname

ID No

Full Name

Initials

Dependent

Gender

Male Female

Marital Status

ANC COP Single Widowed

Date Married

Home Addres

Period

Tel (H)

Tel (W)

Cell

Fax

Email Address

Postal Address

Period

Previous Address

Code

Spouse Name

Spouse Email

Next Of Kin

Relationship

Address

Tel

Employer Details

Employer

Occupation

Employer Address

Tel

No Of Years

Salary Date

Prevous Employer

No Of Years

Spouse Employer

No Of Years

Tel

Occupation

Salary Details

Own Basic Monthly

Other

Spouse Basic Monthly

Other

Bank Details

Bank Name

Branch Name

Branch Code

Name Of account Holder

Account Number

Account Type

Credit Card Savings Transmission Currect

Date

Driving Details

Driver’s License Driving Endorsements

Yes No

Driver’s License Number:

Dirt Road Travel

Yes No

Language Preference

Choose Language

Applicant Initials

Surname

ID Number

Household Income Details

Gross Remuneration

Monthly Commission

Car Allowance Included in Gross

Net Take Home Pay

Income Other Than Salary/Wages

Source of Income

Total

Household & Expense Per Month

Bond Payment / Rent

Rates, Water & Electricity

Vehicle Instalments (Excluding those to be settled)

Personal Loan Repayments

Credit Card Repayment

Furniture Account

Clothing Account

Overdraft Account

Policy/Insurance Repayment

Telephone Payment

Transport Cost

Food and Entertainment

Education Cost

Maintenance

Household Expenses

Other

Total Monthly Household Expenses

Household Surplus/Disposable Income

Are you currently liable as

Specify Details

If you have signed or Co-Debtor, please include the full amount outstanding

Declaration by client

I hereby grant the Owner or Rental Agent of Sai Fleet Car Rental 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.

Yes No

I hereby grant the Owner or Rental Agent of Sai Fleet Car Rental the right to increase my credit limit once every year to accommodate any value-added product needed and requested by me.

Yes No

Date

Or Complete Below Form

Personal Details

Employer Details

Salary Details

Bank Details

Driving Details

Language Preference

Household Income Details

Household & Expense Per Month

Declaration by client

Please note: Information submitted via this form is confidential and stored securely, we do not share details with 3^rd parties.