Application Form

ID. NO.:*
First Names:*
Last Name:*
Title:*
Ethnic Group:
Address:*
Home Tel.:
-
Cell no.:*
E-mail:*
Dependants:*
Married:*
In community of property:*
Name of spouse and ID no.:*
Out of community of property:*
Divorced:*

LOAN INFO

Loan amount:*
Loan period:*
Debt review:*
Blacklisted:*
Administration:*

EMPLOYMENT INFO

Employer name:*
Employee no.:*
Employment Address:
Phone:
-
Phone Extension:
Employment type:*
Department:*
Supervisor Name:*
Employment Year:*
Salary amount:*
Payment type:*
Payment period:*
Monthly pay date:
Fortnight pay date:
Weekly pay date:

BANK ACCOUNT DETAILS

Bank Name:*
Account no.:*
Account type:*
Branch name:
Branch code:*

NEXT OF KIN

Relationship:*
Surname:*
First names:*
Next of kin address:
Kin Work Tel.:
Kin Home Tel.:
Kin Cell:

TOTAL INCOME = A

Extra income:
Maintanance:
Nett salary:*
Overtime:
A = Total Income:*

TOTAL EXPENSES = B

Clothing acc:
Water & electricity.:*
Furniture acc.:
Groceries:*
Insurance:*
Maintenance Expenses:
Medical Aid:
Other Expenses:*
Pension fund:
Bond / Rent:
Tel. Expenses:
Transport Expenses:
B = Total Expenses:*
Total Nett (A - B):

UPLOAD DOCUMENTS REQUIRED TO APPLY

Upload Copy of ID:
Upload Latest Payslip (2mb max):
Upload 3 months bank statements (2mb max):
By submitting this application I agree to the Loufin Terms & Conditions. I hereby authorise Loufin Financial Services to conduct any enquiry necessary to process my application and confirm that I am currently not under administration, sequestration, debt review or a restructuring order. I agree that Loufin Financial Services, may offer me products or services that may interest me via post, phone, email mobile or other means and will always include an opportunity to opt-out of receiving further such offers.
I have read and agree with the terms and conditions on the website located at http://www.loufin.co.za/terms-and-conditions:*
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