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Name & Surname *0 / 80

Loan Amount Requested: *

ID Number *0 / 13

Cellphone Number *0 / 10

Email Address *

Alternative Cellphone Number:0 / 10

Is your Address still the same? *

Street Address

City

Suburb

Province

Postal Code0 / 4

Workplace

Is your employer still the same? *

Employer

Is your position still the same? *

Position

Is your salary frequency and pay date still the same? *

How often do you get paid?

Pay Date:

Paydate Other:

Banking Details

Are your banking details still the same? *

BankWe can only assist clients with bank accounts listed above.

Account Type

Expenses

Please enter your average expenses per month. If an expense is not applicable, please leave it empty.

Rent or Accommodation

Cellphone or Internet

Groceries

Transportation

Utilities (Water & Electricity)

Other (Excluding loan repayments)

Consent

UIA Beneficiary Plan (Optional)YesNoWould you be interested in enrolling in the Beneficiary Plan for a minimal fee of 2% of your loan repayment? This plan ensures that, in the unfortunate event of your passing, your nominated beneficiary will receive a cash payment equivalent to the outstanding value of your loan. The Beneficiary Plan is offered and administered by Universal Insurance Administrators and Underwritten by KGA Life. For more details, click here – https://www.cashloansonline.co.za/uia. KGA Life Limited is a licensed Insured and Authorised Financial Service Provider, FSP No. 15980.

Beneficiary Name & SurnameThis is the person that will receive the funds in the unfortunate event of your death.

Beneficiary ID Number0 / 13

Beneficiary Cell Number

Document Upload

Latest Payslip *

Please provide an uploaded copy of your latest payslip. It cannot be older than 1 month. You can upload multiple files here

3 Months Bank Statements *

No file chosen

Please provide us with 3 months latest bank statements. You can upload multiple files here

Do you have any paid up letters to upload ? *

Paid up Letters

You can upload multiple files here

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