Limit Increase | Koopkrag Application

MEMBER PERSONAL DETAILS

Require fields marked with *

Member Number

Member Title

Spouse Title

Member Full Names

Spouse Full Names

Member Identification Number *Please enter a valid 13-digits South African ID number0 / 13

Spouse Identification NumberPlease enter a valid 13-digits South African ID number0 / 13

Mobile

Spouse Mobile

Email *

Spouse Email

Street Address

PO Box

Suburb

City

Province

Postal Code

Language

Marital Status

Member Employment Bases

Spouse Employment Bases

Member OccupationIf pensioner, please write 'Pensioner'

Spouse OccupationIf pensioner, please write 'Pensioner'

EmployerIf pensioner, please write 'Pensioner'

Spouse EmployerIf pensioner, please write 'Pensioner'

Work Address

AFFORDABILITY ASSESSMENT

Require fields marked with *

Monthly Income

Gross Salary - Applicant

ZAR

Gross Salary - Spouse

ZAR

Other Income - Applicant

ZAR

Other Income - Spouse

ZAR

Please specify

Total Income - Applicant

Total Income - Spouse

Payslip Deductions

Medical Aid - Applicant

ZAR

Medical Aid - Spouse

ZAR

Pension / Provident Fund - Applicant

ZAR

Pension / Provident Fund - Spouse

ZAR

PAYE - Applicant

ZAR

PAYE - Spouse

ZAR

UIF - Applicant

ZAR

UIF - Spouse

ZAR

Other Deductions - Applicant

ZAR

Other Deductions - Spouse

ZAR

Total Deductions - Applicant

Total Deductions - Spouse

Net Salary - Application

Net Salary - Spouse

Monthly Expenses

Accommodation Expense - Applicant

ZAR

Transport Expense - Applicant

ZAR

Food Expense - Applicant

ZAR

Education Expense - Applicant

ZAR

Medical Expense - Applicant

ZAR

Maintenance Expense - Applicant

ZAR

Water & Electricity - Applicant

ZAR

Other Expenses - Applicant

ZAR

Total Expenses - Applicant

Accounts

Asset Finance - Applicant

ZAR

Asset Finance - Spouse

ZAR

Personal Loans - Applicant

ZAR

Personal Loans - Spouse

ZAR

Credit Cards - Applicant

ZAR

Credit Cards - Spouse

ZAR

Bond Repayments - Applicant

ZAR

Bond Repayments - Spouse

ZAR

Cellphone Expense - Applicant

ZAR

Cellphone Expense - Spouse

ZAR

Micro Loans - Applicant

ZAR

Micro Loans - Spouse

ZAR

Security - Applicant

ZAR

Security - Spouse

ZAR

Insurance - Applicant

ZAR

Insurance - Spouse

ZAR

Clothing - Applicant

ZAR

Clothing - Spouse

ZAR

General Retail - Applicant

ZAR

General Retail - Spouse

ZAR

Total Accounts - Applicant

Total Accounts - Spouse

Min Bond Repayment - Applicant

ZAR

Min Bond Repayment - Spouse

ZAR

Disposable Income

Disposable Income Total - Applicant

Disposable Income Total - Spouse

ASSETS & LIABILITIES

If applicable

Assets

Liabilities

Registered Owner of Property

Bond Balance

ZAR

Registered in the name of

Loan Account Balance

ZAR

Fixed Property Market Value

ZAR

Bank Overdraft Balance

ZAR

Furniture

ZAR

Asset Finance Balance

ZAR

Vehicles

ZAR

Surety

ZAR

Other Assets

ZAR

E.g. Investments

Other Liabilities

ZAR

Total Assets

Total Liabilities

Purchase Limit and/or Budget Limit

Current Purchase Limit

Current Budget Limit

New Purchase Limit RequestedApplying for

New Budget Limit RequestedApplying for

CONSUMER DECLARATION

Please upload Proof of Income (Latest Payslip)

Please attach your Latest Payslip

Signed at

Date

Date application completed

Applicant's Signature

Spouse Signature

If applicable

Save as Draft

Koopkrag Limit Increase Application

MEMBER PERSONAL DETAILS

Require fields marked with *