This document is a finance application form for Commonwealth Finance South Africa. It requests personal and financial information from applicants such as identification details, contact information, bank details, employment information, income, expenses, and existing financial obligations. If approved for financing, the applicant would agree to terms such as receiving correspondence via email, consenting to credit checks and identity verification, and consenting to debit order payments.

1. FINANCE
APPLICATION
FORM
Commonwealth Finance
South Africa(Pty)
Ltd
t.a.
GreenFin
Financial
Services Reg.
no.
2012/154097/07
NCR
Reg.
no.
NCRCP6262
Postnet Suite 101, Private Bag X3, Roggebaai, 8012
Unit C9, Century square, Century City, Cape Town,
7441
T:
0861
000
808
F:
086 669 1360
e:
info@greenfin.co.za
ID
number: Bank: Sort
Code:
Surname: Branch
Name:
Contract: Acc
No: Direct
Debit
Date: of
each
month
Surname: First
Name:
Second
Name: ID
number:
Town: RelaTonship: Cell
number:
Code: Time
at
address Y: M: Tel
number: Work
number:
Town: Surname: First
Name:
Code: Second
Name: ID
number:
Telephone: RelaTonship: Cell
number:
Tel
number: Work
number:
Spouse
Home Bonded:
PLEASE
TICK
ALL
OF
THE
BELOW
BOXES
EITHER
YES
OR
NO:
I
agree
to
receive
correspondence
via
e-­‐mail
and
not
by
post Y N
Employer: I
agree
to
a
debit
order
payment
instrucTon
only Y N
Branch: Employee
Nr. I
agree
to
only
receive
communicaTon
only
via
English
or
Afrikaans
(SecTon
129
NCA
2005) Y N
Telephone: OccupaTon: I
declare
that
I
have
not
applied
for
and/or
are
not
currently
under
AdministraTon Y N
Start
Date: HR
Contact: I
declare
that
I
have
not
applied
for
and/or
are
not
currently
under
Debt
Review Y N
Address: I
consent
to
GreenFin
making
enquiries
about
my
credit
record
with
any
third
party
Y N
Suburb: Town: I
consent
to
idenTty
&
fraud
prevenTon
checks
and
sharing
of
informaTon
to
SA
Fraud
PrevenTon
Service Y N
I
consent
to
being
contacted
for
service
feedback
and/or
informaTon
about
other
products
and
services Y N
DescripTon:
Total
Cost
of
Asset
(Rand): Amount
of
Finance
Required
Supplier
Name: Country
Supplier
E-­‐mail:
Signed
at: Date:
Supplier
Telephone: Code: Number:
I
can
provide
addiTonal
surety: Supplier
provides
guaranteed
buyback:
Applicant
Full
names:
TradiTonalCOP *ANC
I
declare
that
the
above
informaTon
is
both
true
and
correct
and
that,
together
with
other
informaTon,
this
will
be
used
to
determine
whether
I
can
afford
the
deducTon
of
the
loan
applied
for.
This
loan
applicaTon
is
subject
to
final
approval
and
may
be
accepted
or
rejected
by
GreenFin
Financial
Services
in
its
sole
and
absolute
discreTon.
NEXT
OF
KIN/SPOUSE
DETAILS
OTHER
RELATION
(not
living
with
you)
Married
BANK
DETAILS
PERSONAL
DETAILS
Mr Ms IniTals:
First
Name:
Marital
Status: Single
No.
of
dependants:
CONTACT
DETAILS
Physical
Address:
Suburb:
Province:
Postal
Address:
Suburb:
Province:
Cellphone:
E-­‐mail:
Residence:
WORK
DETAILS
Y NHome
Owner
GREEN
PRODUCT
INFORMATION
Cheque Savings Transmiss
Ltd Gov Other
Employment: Full
Time Part
Time Temp Contract
Y N NY
Unempl. Self-­‐empl.
Pty(Ltd)
Renting
* Note: Where married in COP, this form needs to be signed by both spouses.
Where applying together with your spouse, a separate application needs to be completed by him/her in
order to perform a credit and affordability check on your combined profiles.
*
Spouse
Full
names:
Applicant
Signature:
Spouse *
Signature:
*Where married CoP, spouse also needs to sign this application form and hereby authorises GreenFin to perform a credit check on his/her profile.

2. Mirrir
(Pty)
Ltd
t.a.
GreenFin
Financial
Services Postnet
Suite
101,
Private
Bag
X3,
Roggebaai,
8012
T: 0861000808
F:0862330027
E:admin@greenfin.co.za
Reg.
no.
2012/154097/07
NCR
Reg.
no.
NCRCP6262
Shop 1&2 La Savina, Century Way, Half Moon Bay,
Island Club, Century City, Cape Town, 7441
PLEASE
NOTE
ALL
FIELDS
MUST
BE
COMPLETED
MONTHLY
INCOME
AND
EXPENSES
DECLARATION FINANCIAL
DEBT
OBLIGATIONS
PAYSLIP
DETAIL Home
Loan(s) Installment
Amount
Gross
salary
(as
per
payslip) R -­‐ R -­‐ R
OverQme
and
commissions R -­‐ R -­‐ R
R -­‐ R -­‐ R
R -­‐ Vehicle
Finance
Agreements Installment
Amount
R -­‐ R -­‐ R
OTHER
MONTHLY
INCOME
(as
per
bank
statements) R -­‐ R
Maintenance
from
spouse R -­‐ R -­‐ R
Rental
income R -­‐ Credit
Cards
/
Store
Credit
cards Installment
Amount
Other
income
-­‐
Specify
source
below: R -­‐ R -­‐ R
R -­‐ R
TOTAL
INDIVIDUAL
INCOME R -­‐ R -­‐ R
Personal
Loan
(s)/
Other
debt
obliga[ons Installment
Amount
EXPENSES
-­‐
CURRENT
OR
ANTICIPATED
(NOT
DEDUCTED
ON
PAYSLIP) R -­‐ R
Transport
costs
R -­‐ R -­‐ R
Food
/
Groceries
R -­‐ R -­‐ R
School
fees
R -­‐ Total R -­‐ R
Telephone
(home
and
cell) R -­‐
Rental
(housing)
R -­‐ PLEASE
CONSENT
TO
THE
FOLLOWING:
Rates
and
Taxes
/
Lights
and
Water
R -­‐
Levy
and
Security
R I
consent
to
obtain
Credit
Life
Insurance
(s44
of
the
Long-­‐Term
Insurance
Act) Y N
Maintenance
/
Court
order
to
spouse
R
-­‐
Insurance
(Life) R
-­‐
I
consent
for
the
upfront
IniQaQon
fee
to
be
financed
with
the
principal
debt? Y N
Insurance
(Short
Term) R
Medical
fees
R
-­‐
Clothing
(not
on
account) R
-­‐
Signed
at: Date:
Entertainment
R
-­‐
Other
expenses R
-­‐
TOTAL
EXPENSES R
-­‐
Full
names: Client
Signature:
Balance
Outstanding
(RANDS
ONLY)
Balance
Outstanding
(RANDS
ONLY)
Balance
Outstanding
(RANDS
ONLY)
Balance
Outstanding
(RANDS
ONLY)
Net
salary
(as
per
payslip)
Court
orders
(incl
garnishee
&
maintenance
deducQons)
Less:
DeducQons
on
payslip
-­‐
-­‐