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Pre-Loan Assessment Form
Service Request Form
Customer Information Sheet
Customer Service Survey
Insurance Quote Form
"
*
" indicates required fields
Full Name
*
Date of Birth
DD slash MM slash YYYY
TRN Number
*
Email Address
*
Phone Number
*
Employer
*
What is your job status?
*
Select
Permanent
On Probation
On Contract
Job Title
*
On Contract
Select
3 Months
6 Months
1 Year
2 Years
Probation
Select
3 Months
6 Months
1 Year
How long have you been at your current job?
*
(If applicable)
Which car (and year) are you interested in buying?
*
Have you spoken to a loan officer regarding financing?
Yes
No
Are you eligible for and will be using duty concessions?
Yes and will be using it
Yes but will not be using it
No
Will you be making a deposit?
Yes
No
How much can you pay per month for the Motor Vehicle of choice?
*
What is your monthly take-home salary?
*
Which financial institution does your salary goes to?
Do you have a NCB account?
*
Yes
No
Are you presently servicing any other loans?
*
Yes
No
Loan amount and time left on the loan
*
Are you currently serving any of the following?
Select
Mortgage
Motor Vehicle Loan
Any Other Loan
N/A
Do you have a driver’s license?
Yes I have a license
Being processed
Just learners license
No drivers license
Do you have any delinquent loans?
*
Yes
No
How soon are you looking to purchase?
MM slash DD slash YYYY
Where did you hear about us?
Select
Instagram
Facebook
Jacars.net
Autoadsja
Others
Email Address
Add email to be a part of our newsletter
(Optional)
Upload your last 3 Pay Slip/Bank Statement
*
Drop files here or
Select files
Accepted file types: pdf, doc, jpg, jpeg, png, Max. file size: 125 MB, Max. files: 8.
Upload your last 3 Pay Slips/Bank Statement. You can upload up to 8 files at a time.
Upload Job Letter
Max. file size: 125 MB.
Drivers License
*
Max. file size: 125 MB.
Agree to our privacy policy and sales agreement.
*
By clicking this checkbox you are agreeing to our Privacy Policy and our Sales Agreement
Sales agreement and privacy policy.
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