Cellphone Agreements by vxs41455


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									                                              PERSONAL FINANCIAL DETAILS
Full names:                                                            ID Nr:

                       MONTHLY INCOME                        MONTHLY EXPENSES
                       Salary Self                           Rent/Bond Repayments
                       Salary Spouse                         HP/Lease Agreements
                       Commissions                           Credit Card Accounts

                       Investments                           Insurance Premiums
                       Other (Specify)                       Loans Repayments
                       TOTAL INCOME                          Entertainment
                       LESS:       Taxation                  Alimony/Maintenance
                                   Pension                   Electricity & Water
                                   UIF                       Groceries
                                   Medical Aid               Clothing Accounts
                                                             Telephone / Cellphone
                                                             Doctor / Chemist
                                                             Domestic / Gardener
                                                             TV Rental / M-Net
                                                             TOTAL EXPENDITURE
                       NETT INCOME                           SURPLUS AVAILABLE

                                    ASSETS                           LIABILITIES
                       Fixed Property 1                      Bondholders                 Amount Owing
                       Address / Stand nr:                   1)
                       Purchase Price:                       2)
                       Year Bought:                          HP Agreements

                       Value                         R       1)
                       Fixed Property 2                      2)
                       Address / Stand nr:                   Due to Banks
                       Purchase Price:                       Bills Payable
                       Year Bought:                          Sundry Creditors
                       Value                         R       Loans
                       Vehicles / Implements                 Bank Overdraft
                       Furniture & Fittings                  Credit Card
                       Investments                           Liability for Income Tax
                       Savings                               Other (Specify)
                       Shares / Stock                        Other (Specify)
                       Surrender value of Policies
                       Other (Specify)                       Total Liabilities
                       Total Assets                          Surplus

I/we hereby consent to Smart Finance (Pty) Ltd or its cessionary making enquiries about my/our credit record with any
credit reference agency and any other part to confirm the details on this application. Smart Finance (Pty) Ltd or its
cessionary may also provide credit reference agencies with regular updates, including how I/we manage my/our
account such as my/our failure to meet agreed terms and conditions. I/we hereby consent that credit reference
agencies may, in turn, make the records and details available to other credit grantors. Smart Finance (Pty) Ltd or its
cessionary may also give this information to any person who, in its opinion, needs it to carry out any of Smart Finance
(Pty) Ltd or its cessionary’s rights or duties in terms of the contract or any law pertaining to the products I/we have

Signature:                                                                Date:

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