Finance Application

Fill in the form below to apply for finance for your New, Demo Ford or Used Car at your convenience. At Casseys Auto Ford we are committed to earning your trust and will do our best to help you secure the Finance you require at the best rate possible.

Application for Installment Finance
Personal Details
Title *
Initials * Surname * ID No *
Full Names *
Dependants
Nationality *
Date Married
Home Address
Period
Tel (H) *
Cell * Fax
Tel (W) Email *
Postal Address *
Code
Previous Address *
Period
Spouse Names
Spouse ID
Next of Kin
Relationship
Address
Tel
Bond Details
Bond Holder
Amount Outstanding
Property Value R
Instalment R /M Purchase Price
Date Purchased
Registered Renting R
Employer Details
Employer *
Occupation *
Industry Type *
Employers Address *
Tel * No of Years
Salary Date *
Previous Employer No of Years
Spouse Employer
No of Years
Tel
Occupation
Salary Details
  Own Spouse Other
Basic Monthly *(excl Car Allow)
Car Allowance
Total Salary Basic & Car Allow
Monthly Commision
Net Take Home Pay
Income other than Salary
Sources of other income
Bank Details
Bank Name *
Branch * Branch Code *
Name of Account Holder * Account number *
Account Type
Settle Existing Account Account No. to settle
Household Income
Bond Payment / Rent Rates, Water & Electricity
Vehicle Installments Personal Loan Repayments
Credit Card Repayments Furniture Accounts
Clothing Accounts Overdraft Repayments
Policy / Insurance Payments Telephone Repayments
Transport Costs Food & Entertainment
Education Costs Maintenance
Household Expenses Other
Total Monthly Household Expenses *
Household Surplus / Disposable income *
Are You Currently Liable As:
Specify Details
If you have signed Surety or Co-Debtor Please Indicate the Full Amount Outstanding
Vehicle Details
Make
Model
Variant
Year
Price
Mileage

I hereby give consent to the credit provider to make enquiries about my credit record with any credit agency and to obtain whatever Information on me they might require to process the application and obtain an insurance quote.

I hereby declare that all of the above information is true and correct.

Use our online Finance Application or call us directly.