Bicycle Finance Application Form

finance APPLICATION FORM

Applicant Name and Surname

Reg. / ID No

Street Address

Code

City

Province

Country

Postal Address

Code

Cellphone Number

Where did you hear about us?

Sales Representative Name

Sales Representative Number

Sales Representative Email

Make and Model

Equipment Price (Incl VAT)

Equipment Quality

Term

Upload Equipment Quote

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FOR INDIVIDUAL APPLICANTS: DOCUMENTS NEEDED: 3 MONTHS BANK STATEMENTS, 3 MONTHS SALARY ADVISES, COPY OF ID

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FOR BUSINESS APPLICANTS: DOCUMENTS NEEDED: 3 MONTHS BANK STATEMENTS, COMPANY REGISTRATION DOCUMENTS, COPY OF ID(DIRECTOR/SHAREHOLDERS)

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I have read and agreed to Terms of Service:

I /We agree that Renewed Group (Pty) Ltd / Finmarque (Pty) Ltd or its cessionary may make inquiries to confirm any information provided by the Company to Renewed Group (Pty) Ltd/Finmarque (Pty) Ltd or its cessionary and that Renewed Group (Pty) Ltd/Finmarque (Pty) Ltd or its cessionary may verify the information and obtain additional information from Experian, a registered credit bureau, or any other third party source (including my bank and CIPC) when assessing the information provided herein.

I authorise Renewed Group (Pty) Ltd/Finmarque (Pty) Ltd or its cessionary to conduct a credit report on the Company, and warrant that all the directors and/or members have consented to the Company instructing Renewed Group (Pty) Ltd/Finmarque (Pty) Ltd or its cessionary to conduct the credit enquiry on the Company.

In the event of the company settling invoices by debit order, Renewed Group (Pty) Ltd/Finmarque (Pty) Ltd or its cessionary will be required to do an account verification check to verify that banking details provided by the Company on the debit order authorisation form, are correct, I hereby authorise such an enquiry.

We furthermore consent to Renewed Group (Pty) Ltd/Finmarque (Pty) Ltd or its cessionary submitting our information, including payment profile and default information and any other relevant information, to any credit bureaux (including to Experian itself) and to allow Experian to release the information for lawful purposes to third parties.

I furthermore warrant that all information supplied to Renewed Group (Pty) Ltd/Finmarque (Pty) Ltd or its cessionary is to the best of my knowledge true and correct, that I am not aware of any other information that would affect the services application of the Company in any way and that I am authorised to submit this document.