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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

    YesNo

    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.