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CREDIT APPLICATION



For Juristic Persons to whom the Consumer Protection Act does not apply

Company Name (required)

Registration Number

Existing Customer
Yes No 

Account Number

Company Type

Street Address (required)

Postal Address (required)

Telephone Number (required)

Fax Number

Business Nature

VAT Number

Date Established

Period under current management

Contact Person (required)

Email Address (required)


Financial Details

Auditors Name

Auditors Contact Number

Bankers

Branch

Account Number

Date

Insurers

Insurers Contact Number

Landlord

Landlord Contact Number

Postal Address


Directors / Members / Shareholders / Partners and / or Company Details

Full Name

ID Number

%

Residential Address

Purchase Price

Value

O/S Bond


Trade References

Name

Contact Number

Account Number / Contract


ANNUAL TURNOVER OR NET ASSET VALUE


CHECK TO ACCEPT TERMS AND CONDITIONS

I/We declare that to the best of my/our knowledge and belief, the particulars set out in this application are true and correct, and that no additional information was withheld. I/We consent to Mercantile Rental Finance making enquiries about my credit record any reference agency and any other party to confirm details on this application. I/We consent to Mercantile Rental Finance carrying out identity and fraud prevention checks and sharing information relating to this application with the South African Fraud Prevention Service.