VAF Personal Application Form_
VAF Personal Application Form_
Personal
Please use block letters and complete the form as completely and accurately as possible, to aid our successful processing of the application.
Individual Joint First time borrower Repeat borrower Your role Primary applicant Co-applicant Guarantor
Personal information
Personal identification
Telephone (country code - area code - phone number, e.g. +263 4 759471)
Address
Residential status Rent Own (bonded) Own (freehold) Living with parents Employer provided
Postal address
Town/City
Guarantor’s/Surety details (Complete only if you are the primary applicant. The guarantor/surety must submit separate personal and financial details forms)
Mobile number
Suburb/district Province
Customer to initial
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Employment details
Address
Town/City
Employment date
Designation Occupation (CCYY-MM-DD)
Financial information
Other Accounts held including Existing loans and other credit facilities
Organisation Facility Type Registered amount Outstanding balance Repayment Tenor Pricing
Remaining
of loan term
Facility (%)
I/We hereby authorise you to debit my/our account and credit my/our Vehicle Asset Finance loan account within 30 (thirty) days upon drawdown* as
per the limit approved.
*Subject to the terms and conditions set out in separate agreements.
I/We authorise you to increase the monthly installment in the event of an increase in the interest rate.
I/We confirm that the information supplied in the application form is true and correct, and that you may use such information to assess the loan application.
Materially incorrect information could lead to this loan facility being withdrawn and intentional or negligent disclosure may lead to possible criminal
liability.
You are authorised but not obliged to act on instructions transmitted by me/us through a w r i t t e n l e t t e r , unless advised to the contrary by
me/us. In the event of late/returned payments, you reserve the right to charge overdue interest or penalties as determined by you.
You are authorised to verify any information given on this application form, and generally make whatever enquiries are necessary from any source
whatsoever.
Primary applicant
Spouse or co-applicant
Surety/Guarantor
Surety/Guarantor
Customer to initial
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Credit Reference Bureau Consent clause
By submitting an application for credit facilities, you agree to be bound by the following requirements relating to the submission of information to the Credit
Reference Bureau whether or not the application for credit facilities is approved;
Definitions
“Credit Reference Bureau” means all credit reference bureaus being utilized by the Bank from time-to-time;
i your credit history, including applications for credit, credit agreements to which you are or have been a party, pattern of payment or default
under any such credit agreements, incidence of enforcement actions with respect to any such credit agreement, the circumstances of termination
of any such credit agreement;
ii your financial history, including your past and current income, assets and liabilities and other matters with respect to your income and
financial means;
iii your education, employment, career, professional or business history, including the circumstances of termination of any employment, career,
professional or business relationship; or
iv your identity, including your name, date of birth, identity number, marital status and family relationships, past and current addresses and other
contact details and related matters.
“Data” means the raw factual information furnished by us to the Credit Reference Bureau including, but not limited to, credit applications, credit agreements,
payment history or patterns or Customer Credit Information collected and arranged by the Credit Reference Bureau and its employees and processed by
the Credit Reference Bureau’s computer systems which are stored in the database
Consent to disclosure of confidential information
You hereby
a irrevocably consent to us collecting, receiving, compiling and retaining any Customer Credit Information about you for purposes of:
iv filing our Customer Credit Information with the Credit Reference Bureau.
b consent to the receipt, sharing, provision and exchange of data with Credit Reference Bureau and with other licensed financial institutions and micro
finance deposit taking institutions through the Credit Reference Bureau;
c acknowledge that the Customer Credit Information obtained may include positive or negative information regarding your payment record;
d acknowledge that the Credit Reference Bureau is required by law to collect negative information on the background and credit history relating to your
nonperforming obligations;
e consent to the collection, recording, retention and submission of all data relating to your economic, financial and commercial obligations in order to
determine your overall debt exposure and ability to pay.
Signature Signature
Name Name
Acceptance
I / We, declare that the information provided by me/us is complete and correct.
Signed at on (YYYY-MM-DD
Full names
Signature(s) Capacity
Customer to initial
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Office use only
Information checklist
Proof of: Checks of:
Identity document Yes No Other credit agreements/facilities Yes No
Six months’ account statements N/A
Employment Yes No Yes No
(another bank)
Income (most recent 3 payslips) Yes No Offer to purchase Yes No N/A
Address (most recent utility statement) Yes No Customer profile updated Yes No N/A
KYC Yes No
Branch
Comments
Number of R/Ds in last six months Number of days in excess prior month
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Office use only
Verification checklist
Six months’ bank account statements (for another bank) Yes No Reason
Credit
Decision
Comments
Conditions
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