Application Self Employed Clients

Dear Applicant,

Thank you for your interest in purchasing a vehicle from Berea Motors. Please complete the application form below to get the process started. It is imperative the form are filled out completely and accurately.

Berea Motors promises to respect your privacy! We will never send you unsolicited ‘junk’ email, or share your data with anyone else who might. If you have any concerns at all please contact us and we will address them quickly and seriously.

*Fields are mandatory

Application Self Employed Clients Louis Heymans

Your Personal Details:

Please provide your personal details.

Name

Middle Name

Surname

Contact Number

ID Number

Address

Marital Status

Gross Salary

Net Salary

Bank Name

Your Monthly Expenses

Please provide your monthly expenses.

Bond/Rent Payment

Water & Electricity Payment

Personal Loans Payment

Credit Card Payment

Furniture Account Payment

Clothing Account Payment

Policy / Insurance Payment

Telephone/contract Payment

Transport Costs

Food and Entertainment

Your Business Details:

Please provide info regarding your business

Name of Business

Contact Number of Business

When did your business start?

Details of Relative

Please provide the details of a relative

Name

Surname

Contact Number of Relative

Address of Relative

Referred by