Chantal van Aswegen- Online Finance Form for Used Cars

Bargain Autos
Showroom
Apply for Finance
Contact

Bargain Autos
Showroom
Apply for Finance
Contact

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Chantal van Aswegen

Sales Executive

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Cell: 079 604 4539
Email: chantelle.bargain.autos@gmail.com

Please note, ALL information you submit is encrypted using SHA256 to ensure your utmost privacy.

If you have any trouble please use the form for legacy devices by clicking here.

Applicant for Finance

Assisted By: *

Referral

Identification Type *

South African ID

ID Number *

ID Number (Confirm) *

Confirm ID Number

Do you have a valid Driver's License? *

Yes
No

Description of Vehicle You're Looking For

Instalment Type *

No Deposit
With Deposit

Deposit Amount *

Personal Details

First Name *

Middle Name

Surname *

Country Nationality *

Preferred Language *

Gender *

Male
Female

Title *

Mr
Advocate
Doctor
Professor
Reverend

Title *

Miss
Mrs
Advocate
Doctor
Professor
Reverend

Race *

Asian
Black
Coloured
White

Marital Status *

Single
Married
Divorced
Widower

Date of Marriage *//

Marital Contract *

ANC (Antenuptial Contract )
COP (Community of Property)
Tribal

Contact Information

Mobile Number *

Mobile Number

Work Number *

Work Number

Mobile Number (Confirm) *

Confirm Mobile Number

Work Number (Confirm) *

Confirm Work Number

Email

Email

Confirm Email

Residential Details

Residential Status *

Owner - Bonded
Owner - Bond Free
Tenant
Lodger
Living With Parents

Outstanding Bond Balance *

Residential Address (Home Address) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Period Here (Years) *

Period Here (Months) *

Employer Details

Employer Name (Company Name) *

Occupation (Job Title) *

Industry Type *

Private
Government
Mining
Farming
Self Employed

Employer Business Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Period Employed (Years) *

Period Employed (Months) *

Income & Expenses

Gross Salary *

As shown on payslip

Net Salary *

As shown on payslip

Frequency of Salary *

Monthly
Weekly
Fortnightly

Total Monthly Income *

Bond Payment

Monthly Rent

Water & Electricity

Car Payments

Personal Loan

Credit Card

Furniture Accounts

Clothing Accounts

Overdraft Payments

Policy / Insurance

Telephone Payments

Transport Costs

Food & Entertainment

Education Costs

Maintenance Expenses

Household Expenses

Relative Details

First Name (Next of Kin) *

Surname (Next of Kin) *

Relation (Next of Kin) *

Phone Number (Next of Kin) *

Address (Next of Kin) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

How did you hear of us? (Optional)

Newspaper Ad
Online Ad
Social Media
Friends
Other

Credit Provider Consent *

Yes, I authorize Murvan's Autos t/a Bargain Autos to share my data with contractually bound credit providers and their partner lenders to retrieve my credit report to assess my creditworthiness before making a final lending decision on my loan application. I authorize Murvan's Autos t/a Bargain Autos to contact, request, and obtain credit information from a registered credit bureau to verify my identity, perform an assessment of my behavior, profile, payment patterns, indebtedness, and creditworthiness, or for other related purposes in any format available from a registered credit bureau.