Kia Empangeni
Tell: (035) 7926508 | Address: 11 Maxwell Street, Empangeni, 3880
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Empangeni
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Welcome to Kia Empangeni Personal Finance Application Form.
If you do not owe anything or do not have any details, fill in with a 0.
Sales Representative
-Select Sales Representative (Not Required)-
AYANDA MABASO
EON FERREIRA
Mananga Ngiba
MUSA MAJOZI
SAMKE BUTHELEZI
Which Vehicle (ie 2010 Toyota 2.0)
-
2019 Blue Kia Rio 1.2 5 Door
2024 White Kia Picanto 1.0 Start
2022 White Kia Rio 1.2 LS 5 Door
2022 White Kia Rio 1.2 LS 5 Door
White Kia Rio 1.2 LS 5 Door
Silver Kia Rio 1.2 LS 5 Door
2021 White Kia K 2700 Workhorse Single Cab
2024 Blue Kia Pegas 1.4 EX Auto
2021 Silver Kia Rio 1.4 EX 5 Door
2020 Whit Kia Seltos 1.5D EX
2021 Copper Stone Kia Sportage 2.0 Ignite+ Auto
2024 White Kia Sonet 1.5 EX CVT
2024 White Kia K 2700 Workhorse Single Cab
2024 Red with Black Roof Kia Seltos 1.6 Ex
2024 Blue Kia Sportage 1.6 CRDI LX Auto
2022 Metallic Snow White Pearl Kia Sorento 2.2D SX AWD Auto
White Mahindra KUV100 NXT K2+ mFalcon Petrol 1.2 #Dare
2014 White Ford Kuga 2.0 TDCI Trend AWD Powershift
2018 Grey Suzuki Vitara 1.6 GL +
White Mahindra Pik Up 2.2 mHawk S6 Single Cab
White Nissan NP200 1.6 8V Base + AC Safety
2021 White Mazda 2 1.5 Dynamic 5 Door
White Volkswagen Polo Vivo 1.4 Trendline 5 Door
2020 Grey Toyota Yaris 1.5 XS 5 Door
2022 Grey Volkswagen Polo Vivo 1.4 Trendline 5 Door
2022 Blue Toyota Urban Cruiser 1.5 Xi
White Mahindra Pik Up Drop Side 2.2 mHawk 4x2 S4
White Mahindra Pik Up 2.2 mHawk SC 4x2 S4
2021 Blue Mazda CX-3 Dynamic
Blue Suzuki Vitara Brezza 1.5 GLX
White Mazda CX-3 Dynamic Auto
White Mahindra Pik Up 2.2 mHawk SC 4x2 S6
Blue Mahindra XUV700 2.0 AX5 Auto
Red Rage Mahindra Scorpio N 2.2D Z4 4X2 Auto
De Sat Silver Mahindra Pik Up 2.2 mHawk Double Cab 4x4 S10
Personal Details
Title
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MR.
MNR.
MISS.
MRS.
MEV.
MS.
DR.
PROF.
PRINCE
Surname
Full Names
Cell Number
Email Address
Sex
-
Male
Female
ID Number
Number Of Dependants
Are you married
-
Yes
No
If you are married, how?
-
Single
Married
Divorced
Widowed
COP
ANC
Date of Marriage (dd/mm/yyyy):
Home Address
:
Street 1:
Street 2:
Street 3:
Suburb :
City :
Postal Code:
How long have you stayed at this address? (Years/Months):
Postal Address
:
P.O. Box 1 :
P.O. Box 2 :
P.O. Box 3 :
P.O. Box Suburb :
P.O. Box City :
P.O. Box Postal Code :
Telephone(Home):
Telephone(Work):
Spouse Name(if Married):
Spouse ID(if Married):
Spouse Cell Number(if Married):
Details of Somebody NOT Living With You
Name:
Surname:
Cell Number:
Relationship
-
Friend
Family
Boss
Address:
Employer Details
Employers Company Name:
Managers Name:
Occupation?(What work do you do?):
How long have you worked there?:
Employers Address:
Employers Telephone:
What date do you get paid:
Banking Details
Who do you Bank With?
-
ABSA
FNB
Nedbank
Standard Bank
Capitec
TYME BANK
Other
No Bank Details
Type of Account?
-
Cheque
Transmission
Savings
Bank Branch Name?:
Bank Account Number?
Bank Branch Number?
Name of Account Holder
Income and Expenses
Total Income Before Deductions
Total Income After Deductions
Total Expenses ie Rent, Vehicles, Food, Telephone, Electricity, etc
Breakdown of Expenses
Bond Payment / Rent
Rates, Water, & Electricity
Vehicle Installments
Personal Loan Repayments
Credit Card Repayments
Furniture Accounts
Clothing Accounts
Overdraft Repayments
Insurance Repayments
Telephone Payment
Transport Costs
Food and Entertainment
Education Costs
Maintenance
Household Expenses
Other
Agreement
I hereby give consent to the Credit Provider to make enquiries about my credit record with any of credit agencies and to obtain whatever information on me that they might require to process the credit application and / or application for insurance. I hereby declare that all of the above information is true and correct
I agree
I hereby give my consent to all related parties for the collection and use of this information. *
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