Client type :
Entity Name :Registration Number :
Trading Name :
Telephone (no spaces) : Fax number (no spaces) :
Registered address: Code :
Postal address:
Represented by: ID number (no spaces) :
Authorised Signatory:
Email : Cell number (no spaces) :
Finance Amount:
Amount Required: R Amount to be Ceded : R
Transaction Property:
Ownership Type :
Erf Number :Suburb :
Estate Agency:
Estate Agency Email:
Contact Person: Contact No (no spaces) :
Email: Estimated Registration Date:
Client's Banking Details:
Bank: A/c number: Branch code:
Account holder: Account type :
The Applicant Warrants:

a) that the above information is accurate and true and that no information that may affect GenFin's decision has been withheld;

Applicant is not the subject of debt counselling or under debt review and will not become over-indebted if

the Bridging Finance is granted; the Applicant is not currently black-listed;

b) that the Transaction Property does not form part of a new development, neither is it a proposed subdivision

and that transfer can be registered immediately;

c) if the Applicant is an Estate Agent, the Applicant warrants being in possession of a current Estate Agent's Board Fedility Fund

Certificate, a copy of which is attached to this Application.

d) that the applicant has not applied nor will they apply for finance at another institution on this transaction.

The Applicant agrees that:

a) GenFin may make all necessary and reasonable enquiries into his/her credit worthiness in considering this application.

SIGNED AT Signature Date: