Professional Documents
Culture Documents
Co-applicant or surety 1
Refer to form number for Main applicant, form number 00141516
Hierdie vorm is ook beskikbaar in Afrikaans, vorm nommer 00142201
Surety
Co-applicant
Section A
Co-Applicant/surety details
Title
Initials
First name
Date of birth
Gender
(YYYY-MM-DD)
Yes
Surname
Identity
type
Married
Marital type
No
Single
Yes
Antenuptial contract?
Identity
number
Country of
citizenship
No
In community of property?
Yes
No
Suburb
Postal code
Suburb
Postal code
Cellphone number
Email address
Solvency
Have you ever been declared insolvent (bankrupt)?
Yes
No
Yes
No
Administration order?
Yes
No
Yes
No
On account of
Bank details
Your main bank
Branch
Account type
Account number
Debit order
Employment details
Current employment type
Permanent
Self-employed
Retired
Unemployed
How are you paid?
Other
(please specify)
Monthly
Weekly
Occupation
Nature of business
Employer telephone number
Employer name
Email address
Postal code
00142191 2011-02
The Standard Bank of South Africa Limited (Reg. No. 1962/000738/06) An authorised financial services and registered credit provider (NCRCP15).
Page 1 of 4
Section B
Extra information
Please fill in information that may affect the Banks decision
Yes
No
If yes, details
Yes
No
If yes, details
As part of our service The Standard Bank of South Africa Limited would like to provide you with information on products and services offered by the group
and other companies, which we believe may benefit you.
Because we regard your personal information as confidential, we need your consent to share it with the group. The group means our affiliates, associates,
subsidiaries and divisions together with our holding company.
Marketing consent
I consent to:
Please tick
applicable
Yes
No
you communicating other companies products, services and special offers to me. If I respond positively to such communication,
I may be contacted by that company.
Yes
No
you sharing my personal information within the group for marketing purposes and the group then marketing its products,
services and special offers to me.
Yes
No
you contacting me for research purposes. (The research companies we use follow strict codes of conduct and treat customer
information confidentially).
Yes
No
Consent
I agree that the Bank may enquire about my credit record with any credit reference agencies to consider this credit application or to update my information.
I agree that the Bank may share information with other credit agencies about how I manage this loan agreement during the time of the loan.
The agencies may share this information with other credit providers.
I also agree that the Bank may carry out identity and fraud prevention checks and share information relating to this application with the South African Fraud
Prevention Service.
I agree that I will be responsible for the administration fees and wasted costs that the Bank incurs if I cancel my loan request after the Bank has granted it.
Please note that if you are married in Community of Property, this agreement will be in both you and your spouses names.
I confirm that the information I have given is correct and a true reflection of my financial position and that there is no other information that would affect the
Banks decision to approve the loan.
Signatures
Co-applicant/surety 1
Date (YYYY-MM-DD)
Contact details
00142191 2011-02
Page 2 of 4
Co-applicant
Section A
Co-Applicant/surety details
Title
Initials
First name
Date of birth
Gender
(YYYY-MM-DD)
Yes
Surname
Identity
type
Married
Marital type
No
Single
Yes
Antenuptial contract?
Identity
number
Country of
citizenship
No
In community of property?
Yes
No
Suburb
Postal code
Suburb
Postal code
Cellphone number
Email address
Solvency
Have you ever been declared insolvent (bankrupt)?
Yes
No
Yes
No
Administration order?
Yes
No
Yes
No
On account of
Bank details
Your main bank
Branch
Account type
Account number
Debit order
Employment details
Current employment type
Permanent
Self-employed
Retired
Unemployed
How are you paid?
Other
(please specify)
Monthly
Weekly
Occupation
Nature of business
Employer telephone number
Employer name
Email address
Postal code
00142191 2011-02
The Standard Bank of South Africa Limited (Reg. No. 1962/000738/06) An authorised financial services and registered credit provider (NCRCP15).
Page 3 of 4
Section B
Extra information
Please fill in information that may affect the Banks decision
Yes
No
If yes, details
Yes
No
If yes, details
As part of our service The Standard Bank of South Africa Limited would like to provide you with information on products and services offered by the group
and other companies, which we believe may benefit you.
Because we regard your personal information as confidential, we need your consent to share it with the group. The group means our affiliates, associates,
subsidiaries and divisions together with our holding company.
Marketing consent
I consent to:
Please tick
applicable
Yes
No
you communicating other companies products, services and special offers to me. If I respond positively to such communication,
I may be contacted by that company.
Yes
No
you sharing my personal information within the group for marketing purposes and the group then marketing its products,
services and special offers to me.
Yes
No
you contacting me for research purposes. (The research companies we use follow strict codes of conduct and treat customer
information confidentially).
Yes
No
Consent
I agree that the Bank may enquire about my credit record with any credit reference agencies to consider this credit application or to update my information.
I agree that the Bank may share information with other credit agencies about how I manage this loan agreement during the time of the loan.
The agencies may share this information with other credit providers.
I also agree that the Bank may carry out identity and fraud prevention checks and share information relating to this application with the South African Fraud
Prevention Service.
I agree that I will be responsible for the administration fees and wasted costs that the Bank incurs if I cancel my loan request after the Bank has granted it.
Please note that if you are married in Community of Property, this agreement will be in both you and your spouses names.
I confirm that the information I have given is correct and a true reflection of my financial position and that there is no other information that would affect the
Banks decision to approve the loan.
Signatures
Co-applicant/surety 2
Date (YYYY-MM-DD)
Contact details
00142191 2011-02
Page 4 of 4