www.capefin.co.za

COMMERCIAL ASSET FINANCE

INVOICE DISCOUNTING

APPLICANT:

Individual / Sole Proprietorship Company Close Corporation Partnership Trust

DETAILS OF APPLICANT: Individual (individuals applying jointly must each complete a separate application form)

Full Names Identity Number

Physical Address Postal Address

Telefax Number E-mail Address

Cell Number Telephone Number

If Married in Community of Property:

Full Names of Spouse

Physical Address of Spouse

Identity Number of Spouse Telephone Number

Next of Kin:

Name Contact Number

Relationship

Company:

Name of Company

Registration Number VAT Number

Trading Name (if any)

Registered Address (physical address) Principal Place of Business (physical address)

Reference Person

Telephone Number Telefax Number

Email Address

Trade Reference:

Company Name

Contact Name Contact Number

FINANCIAL DETAILS:

Banking Details:

Name of Bank Account Holder

Account Number Branch

Branch Code

Type of Account Current Savings Loan / Asset Finance Credit Card Other (Specify)

APPLICATION FORM

File Name:For office use only:

CAPE TOWN OFFICEGround Floor, Building 4, Unit 401, De Tijger Office Park Cnr McIntyre Road & Hannes Louw Drive, Parow 7500PO Box 15801, Panorama 7506 I Tel: 021 911 2603 I Telefax: 021 911 2478

PRETORIA OFFICEBlock C, Grain Building Agri Hub Office Park, 477 Witherite StreetThe Willows, Pretoria 0184 I Tel: 012 003 4564

Status: (to be completed by individuals only)Has the applicant ever been sequestrated Yes No If yes, Date

Date of rehabilitation

Declaration: I hereby declare that to the best of my knowledge and belief the information furnished above is true and correct. I

undertake and warrant that my/the applicant’s assets are not encumbered (otherwise as stated above). I consent that CFC may

perform a credit search on my/the applicant’s credit record at any registered credit bureau when assessing this application for credit,

monitor my/the applicant’s payment behaviour by researching my/applicant’s records at any registered credit bureau and use new

information and data obtained from any registered credit bureau in respect of this application for credit. I consent that any bank may

provide information and/or a credit rating in respect of me/the applicant on request of CFC.

I Accept

Signed at On

Full Names

Capacity (if signing on behalf of another)

Director Member Trustee Partner Of�ce Bearer Other (Specify)

Signature

APPLICANT:

Individual / Sole Proprietorship Company Close Corporation Partnership Trust

DETAILS OF APPLICANT: Individual (individuals applying jointly must each complete a separate application form)

Full Names Identity Number

Physical Address Postal Address

Telefax Number E-mail Address

Cell Number Telephone Number

If Married in Community of Property:

Full Names of Spouse

Physical Address of Spouse

Identity Number of Spouse Telephone Number

Next of Kin:

Name Contact Number

Relationship

Company:

Name of Company

Registration Number VAT Number

Trading Name (if any)

Registered Address (physical address) Principal Place of Business (physical address)

Reference Person

Telephone Number Telefax Number

Email Address

Trade Reference:

Company Name

Contact Name Contact Number

FINANCIAL DETAILS:

Banking Details:

Name of Bank Account Holder

Account Number Branch

Branch Code

Type of Account Current Savings Loan / Asset Finance Credit Card Other (Specify)

Status: (to be completed by individuals only)Has the applicant ever been sequestrated Yes No If yes, Date

Date of rehabilitation

Declaration: I hereby declare that to the best of my knowledge and belief the information furnished above is true and correct. I

undertake and warrant that my/the applicant’s assets are not encumbered (otherwise as stated above). I consent that CFC may

perform a credit search on my/the applicant’s credit record at any registered credit bureau when assessing this application for credit,

monitor my/the applicant’s payment behaviour by researching my/applicant’s records at any registered credit bureau and use new

information and data obtained from any registered credit bureau in respect of this application for credit. I consent that any bank may

provide information and/or a credit rating in respect of me/the applicant on request of CFC.

I Accept

Signed at On

Full Names

Capacity (if signing on behalf of another)

Director Member Trustee Partner Of�ce Bearer Other (Specify)

Signature

SUPPORTING DOCUMENTS: (The following documents must accompany this application)1. Brief company background and motivation in support of the application for �nance.

2. Most recent annual �nancial statements, audited in the case of companies.

3. Management accounts since last year end.

4. Most recent income tax return bearing the applicant’s income tax number.

5. A recent utility bill showing the applicant’s physical address.

6. Current account bank statements for last three months.

7. Certi�ed copies of the identity documents of the applicant/directors/members/sureties.

8. Certi�ed copies of the antenuptial contract of the consumer (if the consumer is married out of community of property).9. The identity document/s of the consumer’s spouse (if the consumer is married in community of property).10. Pay slip of the applicant (if the applicant is an individual).11. If the consumer is a company:

- the memorandum and articles of association of the consumer

- the certi�cate to commence business of the consumer

- the most recent CM 29 of the consumer

- the identity documents of all directors of the consumer

- an extract from the register of members of the consumer

12. If the consumer is a close corporation:

- the CK1 of the consumer

- any CK2 of the consumer

- the identity documents of all members of the consumer

13. If the consumer is a trust:

- the trust deed of the consumer

- the letters of authority in respect of the trustees of the consumer

- the identity documents of the trustees

14. If the consumer is a partnership:

- the partnership agreement, if any

- the identity documents of the partners

15. If the applicant is an association:

- the constitution of the association

- identity documents of the of�ce bearers

APPLICANTS REQUIRING ASSET FINANCE (In addition to the aforegoing information)1. Pro forma invoice addressed to CFC

2. Photograph of the asset