Company Finance Loan Personal

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					                                                     LOAN APPLICATION

                                         Please fax to: 086 509 9803 email:

Loan Details

Loan Amount                                                     Loan Term                                  Installment Amount

Applicant Personal Details

Email Address

Title                                                                               Language

Surname                                                                             Full names

ID Number                                                                           Address Details

Work Number                                                                         Line 2

Cell Number                                                                         Suburb

Home Number                                                                         City

Nationality                         South African                                   Postal Code

Pre-Qualify & Marketing Information

1) Own or joint Bank Account with 2 months Salary deposited?                       Yes         NO        Bank Name

2) Are you under the following?     1) Administration   2) Debt Councelling      3) Debt Review      4) Sequestration or 5) Liquidation               YES     No

3) Can we include Maravedi Credit Life Cover ?                                     Yes              NO     If No - Policy to be ceded

4) My preferred method of communication is:             SMS      E-Mail     Post         Tel                    Loan Purpose

Employment Details

Gross Salary                                                                        Net Salary

Company Name
                                                                                    Period Employed                      Years                     Months
                                                                                                                           Monthly        Weekly
Department                                                                          Payment Frequency

Salary Pay Date

                         Perm          Self          contract             temp
Employment Status

Acknowledgement, Consent and Authorisation by Applicant
 I declare that the above information is both true and correct. This application is subject to final approval and may be accepted or rejected by Meridian Finance at
   its sole discression, subject to it's formal credit assessment processes. I consent to Meridian Finance making enquiries about my credit record with any credit
reference agency or with any party as per the information provided by me. I further consent to Meridian Finance carrying out identity and fraud prevention checks.

    I ………………………………………. (Agent) confirm to
    have authority from the abovementioned client to sign on
    his/her behalf.                                                                 Date                                     Signature of Agent

2010/01/06 Ver.1.1

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