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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
Do you pay any of the following via your Account?
Rent
Light Bill
Water Bill
Internet Bill
Partner
None of the Above
If you pay any of the Above How much is it?
Are you presently servicing any other loans?
*
Yes
No
Loan type
*
What is your current monthly payment?
*
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
Upload Reciept
*
Max. file size: 64 MB.
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
*
Upload your last 3 Pay Slips. You can upload up to 5 files at a time.
Drop files here or
Select files
Accepted file types: pdf, doc, jpg, jpeg, png, Max. file size: 125 MB, Max. files: 5.
Upload your last 6 months Bank Statement
*
Upload your last 6 months Bank Statement. You can upload up to 8 files at a time.
Drop files here or
Select files
Accepted file types: pdf, doc, jpg, jpeg, png, Max. file size: 125 MB, Max. files: 8.
Upload Job Letter
*
Max. file size: 125 MB.
Drivers License
Please upload both the front and back of your driver's license. You can upload up to 2 files at a time.
Drop files here or
Select files
Accepted file types: pdf, doc, jpg, jpeg, png, Max. file size: 64 MB, Max. files: 2.
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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